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General NPI Number Information
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NPI Number | 1245737550
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Entity Type | Individual
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Provider Name | HONG-GIL CHAE
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Gender | Male
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Dates
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Enumeration Date | 04/12/2018
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Last Update Date | 05/01/2020
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Provider Practice Location Address
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Address Line | 549 N MAIN ST
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City | CORNELIA
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State | GA
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Zip | 30531-2328
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Country | US
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Telephone | 706-778-5097
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Fax |
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Provider Business Mailing Address
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Address Line | 2731 REFLECTION DR
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City | BUFORD
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State | GA
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Zip | 30519-7617
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Country | US
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Telephone |
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH030330
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License Number State | GA
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