Healthcare Provider Details

I. General information

NPI: 1558285346
Provider Name (Legal Business Name): KI-PYO JASON HONG PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5121 S COTTONWOOD ST
MURRAY UT
84107-5701
US

IV. Provider business mailing address

244 W VINE ST
MURRAY UT
84107-5492
US

V. Phone/Fax

Practice location:
  • Phone: 248-787-1926
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number23571-40
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: