Healthcare Provider Details

I. General information

NPI: 1619319654
Provider Name (Legal Business Name): HYUNWOO RIM PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2013
Last Update Date: 07/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 S ARAPEEN DR STE 102
SALT LAKE CITY UT
84108-1230
US

IV. Provider business mailing address

675 S ARAPEEN DR STE 102
SALT LAKE CITY UT
84108-1230
US

V. Phone/Fax

Practice location:
  • Phone: 801-587-8785
  • Fax:
Mailing address:
  • Phone: 801-587-8785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number8024905-1701
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: