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General NPI Number Information
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NPI Number | 1376139261
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Entity Type | Individual
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Provider Name | DR. NYMO T LIM
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Gender | Male
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Dates
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Enumeration Date | 12/15/2020
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Last Update Date | 12/15/2020
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Provider Practice Location Address
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Address Line | 2523 PLEASANT CREST CT
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City | NEWARK
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State | OH
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Zip | 43055-8048
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Country | US
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Telephone | 316-587-5454
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Fax |
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Provider Business Mailing Address
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Address Line | 2523 PLEASANT CREST CT
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City | NEWARK
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State | OH
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Zip | 43055-8048
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Country | US
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Telephone | 316-587-5454
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03236905
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License Number State | OH
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