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General NPI Number Information
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NPI Number | 1538215231
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Entity Type | Organization
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Legal Business Name | KIMMY PHARMACY
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1435 DORCHESTER AVE
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City | DORCHESTER
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State | MA
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Zip | 02122-2915
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Country | US
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Telephone | 617-288-8199
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Fax | 617-288-8191
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Provider Business Mailing Address
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Address Line | 1435 DORCHESTER AVE
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City | DORCHESTER
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State | MA
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Zip | 02122-2915
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Country | US
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Telephone | 617-288-8199
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Fax | 617-288-8191
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Authorized Official
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Title or Position | OWNER
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Name | MR. TUAN TRAN
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Credential | RPH
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Telephone | 617-288-8199
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 1888
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 1888
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License Number State | MA
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