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General NPI Number Information
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NPI Number | 1184575110
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Entity Type | Individual
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Provider Name | SUNGHO CHRISTIAN PARK PHARMD
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Gender | Male
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Dates
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Enumeration Date | 02/05/2026
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Last Update Date | 02/05/2026
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Provider Practice Location Address
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Address Line | 2205 FONTAINE AVE
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22903-2976
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Country | US
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Telephone | 434-297-7555
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Fax | 434-297-4495
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Provider Business Mailing Address
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Address Line | 2205 FONTAINE AVE
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22903-2976
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Country | US
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Telephone | 434-297-7555
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Fax | 434-297-4495
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number | 0202218660
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License Number State | VA
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