Provider Demographics
NPI:1346540143
Name:LIM, YOUNG C (RPH)
Entity Type:Individual
Prefix:MR
First Name:YOUNG
Middle Name:C
Last Name:LIM
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 SYLVESTOR PL
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-6200
Mailing Address - Country:US
Mailing Address - Phone:720-217-1799
Mailing Address - Fax:
Practice Address - Street 1:9255 S BROADWAY
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129-5631
Practice Address - Country:US
Practice Address - Phone:303-683-0511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-26
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO12620183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist