MEDICARE: WOOJIN KIM

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	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1396473534
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WOOJIN KIM

Provider Business Mailing Address
First Line	:	1421 CHERRY RD
Second Line	:
City	:	BLUE BELL
State	:	PA
Zip	:	19422-1805
Country	:	US
Telephone Number	:	267-884-1224
Fax Number	:

Provider Business Practice Location Address
First Line	:	1421 CHERRY RD
Second Line	:
City	:	BLUE BELL
State	:	PA
Zip	:	19422-1805
Country	:	US
Telephone Number	:	267-884-1224
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/14/2022
Last Update Date	:	08/14/2022

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Directions to “ WOOJIN KIM ” Practice Location

Language	Start Address	Practice Location

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