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NPI Code Detail

MEDICARE: DR. ILNAE CLARA NAMGUNG PHARMD

MEDICARE:  DR. ILNAE CLARA NAMGUNG  PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistRPH022634GA
2183500000XPharmacist5302033635MI

General Provider Information

NPI Number : 1821387903
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ILNAE CLARA NAMGUNG PHARMD
Provider Business Mailing Address
First Line : 2325 PLEASANT HILL RD
Second Line :
City : DULUTH
State : GA
Zip : 30096-1753
Country : US
Telephone Number : 770-497-4425
Fax Number : 770-814-2327
Provider Business Practice Location Address
First Line : 2325 PLEASANT HILL RD
Second Line :
City : DULUTH
State : GA
Zip : 30096-1753
Country : US
Telephone Number : 770-497-4425
Fax Number : 770-814-2327
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2011
Last Update Date : 03/29/2011

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Directions to “ DR. ILNAE CLARA NAMGUNG PHARMD” Practice Location

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