Provider Demographics
NPI:1144691353
Name:HO, SUNG SHENG (PHARMD)
Entity type:Individual
Prefix:
First Name:SUNG
Middle Name:SHENG
Last Name:HO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 EASY ST APT A
Mailing Address - Street 2:
Mailing Address - City:BROOKINGS
Mailing Address - State:OR
Mailing Address - Zip Code:97415-8123
Mailing Address - Country:US
Mailing Address - Phone:714-808-3367
Mailing Address - Fax:
Practice Address - Street 1:16261 HIGHWAY 101 S
Practice Address - Street 2:
Practice Address - City:HARBOR
Practice Address - State:OR
Practice Address - Zip Code:97415-9499
Practice Address - Country:US
Practice Address - Phone:541-469-3121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-14
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0015036183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist