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NPI Code Detail

MEDICARE: NGOC KIM

MEDICARE: NGOC KIM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist017423LA

General Provider Information

NPI Number : 1316240286
Entity Type Code : Individual
Provider Name (Legal Business Name) : NGOC KIM
Provider Business Mailing Address
First Line : 3671 JOOR RD
Second Line :
City : BATON ROUGE
State : LA
Zip : 70814-3104
Country : US
Telephone Number : 225-924-3880
Fax Number :
Provider Business Practice Location Address
First Line : 3671 JOOR RD
Second Line :
City : BATON ROUGE
State : LA
Zip : 70814-3104
Country : US
Telephone Number : 225-924-3880
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2010
Last Update Date : 12/14/2010

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Directions to “ NGOC KIM ” Practice Location

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