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General NPI Number Information
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NPI Number | 1427749878
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Entity Type | Organization
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Legal Business Name | KIMAR LLC
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Dates
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Enumeration Date | 05/17/2023
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Last Update Date | 05/17/2023
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Provider Practice Location Address
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Address Line | 239 LOUDON RD STE 1A
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City | CONCORD
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State | NH
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Zip | 03301-6091
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Country | US
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Telephone | 603-225-2747
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Fax | 603-227-6170
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Provider Business Mailing Address
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Address Line | 239 LOUDON RD STE 1A
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City | CONCORD
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State | NH
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Zip | 03301-6091
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Country | US
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Telephone | 603-225-2747
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Fax | 603-227-6170
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Authorized Official
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Title or Position | NUTRITIONAL PHARMACIST
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Name | MARTIN DONOVAN
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Credential | R.PH, DCN, DIP HERB
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Telephone | 603-225-2747
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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