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NPI Code Detail

MEDICARE: HEARYUN KIM RPH

MEDICARE: HEARYUN KIM RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist046833NY

General Provider Information

NPI Number : 1154644086
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEARYUN KIM RPH
Provider Business Mailing Address
First Line : 270 EXCHANGE BLVD
Second Line : APT 125
City : ROCHESTER
State : NY
Zip : 14608-2768
Country : US
Telephone Number : 585-461-3197
Fax Number :
Provider Business Practice Location Address
First Line : 2580 E HENRIETTA RD
Second Line :
City : ROCHESTER
State : NY
Zip : 14623-4526
Country : US
Telephone Number : 585-321-2581
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2010
Last Update Date : 03/05/2010

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