JAESUNG LEE (NPI# 1023460656) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023460656 |
| Entity Type | Individual |
| Full Name | JAESUNG LEE |
| Credential | RPH |
| Practice Address |
211 W Lake St Tawas City MI 48763-9274 |
| Practice Telephone | 9893623439 |
| Mailing Telephone | 9893623439 |
| Enumeration Date | 2016-07-07 |
| Last Update Date | 2016-07-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | 03135399 | OH | Pharmacy Service Providers |
| Y | 183500000X | Pharmacist | 5302040620 | MI | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801027354 | Jaesung Lee | General Practice | 112-50, 72nd Avenue, Apt-704, Forest Hills, NY 11375 | 2009-07-31 |
| 1376550715 | Jaesung Lee | Otolaryngology | 301 S Moorpark Rd, Thousand Oaks, CA 91361-1008 | 2006-08-01 |
| Street Address |
211 W LAKE ST |
| City | TAWAS CITY |
| State | MI |
| Zip Code | 48763-9274 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730479262 | Kenneth Lee Mckenzie | Pharmacist | 211 W Lake St, Tawas City, MI 48763-9274 | 2011-04-18 |
| 1003284217 | Rite Aid | Pharmacist | 211 W Lake St, Tawas City, MI 48763-9274 | 2015-09-03 |
| 1861801193 | Eric Halaka | Pharmacist | 211 W Lake St, Tawas City, MI 48763-9274 | 2014-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720447006 | Josie Short | Student in an Organized Health Care Education/Training Program | 127 Wheeler Street, Tawas, MI 48763 | 2016-02-16 |
| 1689052698 | Victoria Mcgillis | Nurse Practitioner | 325 E M 55 Ste B, Tawas City, MI 48763 | 2015-05-11 |
| 1942500160 | Jeffrey M Chadwick O D P C | Optometrist | 325 M-55, Tawas City, MI 48763 | 2010-10-22 |
| 1659536068 | Josip Petani | Pediatrics | 101 W. Lake St, Tawas City, MI 48763 | 2008-07-24 |
| 1790963312 | Phillip A Wienczewski Pllc | Dentist | 671 E M 55, Tawas City, MI 48763 | 2008-02-06 |
| 1902090038 | Life Family Chiropractic LLC | Chiropractor | 196 M 55, Life Family Chiropractic, Tawas City, MI 48763 | 2007-08-31 |
| 1467586446 | Thomas Aldrich Dawson | Dentist | 508 Hemlock Avenue, Tawas City, MI 48763 | 2007-03-14 |
| 1497819056 | Phillip Allen Wienczewski | Dentist | 671 E M55, Tawas City, MI 48763 | 2006-12-20 |
| 1821163106 | Charles Edward Kudwa | Dentist | 510 West Lake St, Tawas City, MI 48763 | 2006-11-21 |
| 1720017312 | Jeffrey Michael Chadwick | Optometrist | 325 M-55 East, Tawas City, MI 48763 | 2006-07-03 |
| Find all providers in zip 48763 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730479262 | Kenneth Lee Mckenzie | Pharmacist | 211 W Lake St, Tawas City, MI 48763-9274 | 2011-04-18 |
| 1801441126 | Steven Lee Buchman | Pharmacist | 621 E Lake St, Tawas City, MI 48763-9213 | 2019-08-04 |
| 1497107833 | Molly Reynolds | Pharmacist | 621 E Lake St, Tawas City, MI 48763-9213 | 2016-07-11 |
| 1003284217 | Rite Aid | Pharmacist | 211 W Lake St, Tawas City, MI 48763-9274 | 2015-09-03 |
| 1861801193 | Eric Halaka | Pharmacist | 211 W Lake St, Tawas City, MI 48763-9274 | 2014-08-12 |
| 1629305354 | Stacy Michelle Shoen | Pharmacist | 200 Hemlock St, Tawas City, MI 48763-9237 | 2009-11-18 |
| 1275613994 | Scott W Somerfield | Pharmacist | 306 W Lake St, Tawas City, MI 48763-8308 | 2006-10-17 |
| 1629158357 | Julie Blust | Pharmacist | 306 W Lake St, Tawas City, MI 48763-8308 | 2006-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609477710 | Alix Sabbagh | Pharmacist | 154 River Ln, Dearborn, MI 48124-1047 | 2020-11-04 |
| 1659972867 | Bruce Alan Gilmore | Pharmacist | 5940 Augusta Ln, Grand Blanc, MI 48439-9473 | 2020-11-04 |
| 1437750551 | Anamiben R Patel | Pharmacist | 45555 Michigan Ave, Canton, MI 48188-2388 | 2020-11-04 |
| 1871194217 | Rajesh Koduru | Pharmacist | 27496 Pamplona Ln, Novi, MI 48374-4208 | 2020-11-03 |
| 1346841962 | Joy Emery | Pharmacist | 1770 N Alger Road, Alma, MI 48001 | 2020-11-02 |
| 1659972107 | Jane Gruenke | Pharmacist | N10305 Country Club Rd, Ironwood, MI 49938-9627 | 2020-11-02 |
| 1407456254 | Bradley Dwane Murphy | Pharmacist | 6170 S Saginaw, Grand Blanc, MI 48439 | 2020-10-30 |
| 1811597602 | Rachel L Martin | Pharmacist | 600 N Center Ave, Gaylord, MI 49735-1506 | 2020-10-29 |
| 1760081467 | Sam Nasser | Pharmacist | 6610 Reuter St, Dearborn, MI 48126-1898 | 2020-10-22 |
| 1427656990 | Tejal Shah | Pharmacist | 1153 Pembroke Dr, Rochester Hills, MI 48307-5756 | 2020-10-15 |
| Find all providers with the same taxonomy | ||||
| City | TAWAS CITY |
| Zip Code | 48763 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.