IndividualActive
Jin Won Park
NPI 1104385467 · Pharmacist · Laurel, MD
Provider details
- NPI number
- 1104385467
- Entity type
- Individual
- Primary specialty
- PharmacistPharmacy Service Providers
- Sex
- Male
- Sole proprietor
- No
- License
- 22887 (MD)
Specialties & taxonomies
Pharmacy Service Providers
Profile Score
Established profile(66/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
667 Main St
Laurel, MD 20707-4067
Phone: (301) 317-3838
Fax: (301) 317-3637
Street-level locationGet directions
Mailing address
667 Main St
Laurel, MD 20707-4067
Registry dates
- Enumerated
- 2019-03-17
- Last updated
- 2019-04-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.