Provider Demographics
NPI:1861273229
Name:KONG, MEE
Entity type:Individual
Prefix:
First Name:MEE
Middle Name:
Last Name:KONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MEE
Other - Middle Name:
Other - Last Name:THAO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:304 GREENVALLEY PL NE
Mailing Address - Street 2:
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645-3628
Mailing Address - Country:US
Mailing Address - Phone:828-379-3250
Mailing Address - Fax:
Practice Address - Street 1:1504 2ND ST NE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-2551
Practice Address - Country:US
Practice Address - Phone:828-322-3037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-11
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC31859183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist