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General NPI Number Information
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NPI Number | 1578435939
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Entity Type | Individual
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Provider Name | KYUNGEUN KIM YIM
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Gender | Female
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Dates
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Enumeration Date | 09/23/2025
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 10820 ABBOTTS BRIDGE RD STE 240
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City | JOHNS CREEK
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State | GA
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Zip | 30097-5783
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Country | US
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Telephone | 470-223-4775
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Fax |
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Provider Business Mailing Address
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Address Line | 4340 ELVIE WAY
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City | HOSCHTON
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State | GA
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Zip | 30548-1816
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Country | US
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Telephone | 404-988-9253
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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 | RPH030800
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License Number State | GA
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