Provider Demographics
NPI:1366942468
Name:SONG, KAREN HEE (RPH)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:HEE
Last Name:SONG
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:SUPERDRUG OKA
Mailing Address - Street 2:285 FARENHOLT AVENUE STE#304
Mailing Address - City:TAMUNING
Mailing Address - State:GUAM
Mailing Address - Zip Code:96913
Mailing Address - Country:UM
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:SUPERDRUG OKA
Practice Address - Street 2:285 FARENHOLT AVENUE STE#304
Practice Address - City:TAMUNING
Practice Address - State:GUAM
Practice Address - Zip Code:96913
Practice Address - Country:UM
Practice Address - Phone:671-646-6177
Practice Address - Fax:671-649-2724
Is Sole Proprietor?:No
Enumeration Date:2018-02-15
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GUPH077183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist