MEDICARE: KIM DO INC

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
1	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205961091
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KIM DO INC

Provider Business Mailing Address
First Line	:	2510 N FRONT ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19133
Country	:	US
Telephone Number	:	215-634-3939
Fax Number	:

Provider Business Practice Location Address
First Line	:	2510 N FRONT ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19133
Country	:	US
Telephone Number	:	215-634-3939
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. NGAN KIM DO
Credential	:	RPH
Telephone Number	:	215-634-3939

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	08/30/2011

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Directions to “KIM DO INC ” Practice Location

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