Kim DO, R.PH
Individual provider Active NPI Pharmacist · Radcliff, KY
NPI 1750831038 · NPPES record last updated Oct 10, 2016
Key facts
- NPI
- 1750831038
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 018873 (KY)
- Practice address
- 635 S Dixie Blvd
Radcliff, KY 40160-1219 - Phone
- (270) 352-0880
- NPI assigned
- Oct 10, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 018873 | KY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 018873 | KY | Yes |
Addresses
Primary practice location
635 S Dixie Blvd
Radcliff, KY 40160-1219
Mailing address
635 S Dixie Blvd
Radcliff, KY 40160-1219
Phone (270) 352-0880
Other providers in Radcliff, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.