Healthcare Provider Details

I. General information

NPI: 1205346277
Provider Name (Legal Business Name): SANDY LIM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2017
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4805 BATTERY LN
BETHESDA MD
20814-2701
US

IV. Provider business mailing address

4805 BATTERY LN
BETHESDA MD
20814-2701
US

V. Phone/Fax

Practice location:
  • Phone: 240-802-2952
  • Fax: 240-630-8644
Mailing address:
  • Phone: 240-802-2952
  • Fax: 240-630-8644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number25123
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: