Provider Demographics
NPI:1487762951
Name:FONG, PERRY YEE (RPH)
Entity type:Individual
Prefix:
First Name:PERRY
Middle Name:YEE
Last Name:FONG
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5580 US 25/70 HWY
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:NC
Mailing Address - Zip Code:28753-6499
Mailing Address - Country:US
Mailing Address - Phone:828-649-1636
Mailing Address - Fax:
Practice Address - Street 1:5580 US HIGHWAY 25/70
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:NC
Practice Address - Zip Code:28753-6499
Practice Address - Country:US
Practice Address - Phone:828-649-1636
Practice Address - Fax:828-649-1784
Is Sole Proprietor?:No
Enumeration Date:2006-08-26
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17860183500000X
FL20282183500000X
AL10662183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist