MEDICARE: MS. HOJUNG KIM RPH

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
1	183500000X	Pharmacist	048611	NY

General Provider Information

NPI Number	:	1346427747
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. HOJUNG KIM RPH

Provider Business Mailing Address
First Line	:	21967 67TH AVE
Second Line	:	2ND FLOOR
City	:	OAKLAND GARDENS
State	:	NY
Zip	:	11364-2638
Country	:	US
Telephone Number	:	718-225-5167
Fax Number	:

Provider Business Practice Location Address
First Line	:	21967 67TH AVE
Second Line	:	2ND FLOOR
City	:	OAKLAND GARDENS
State	:	NY
Zip	:	11364-2638
Country	:	US
Telephone Number	:	718-225-5167
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/28/2008
Last Update Date	:	01/28/2008

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