Provider Demographics
NPI:1417034380
Name:LIMS FAMILY PHARMACY INC
Entity Type:Organization
Organization Name:LIMS FAMILY PHARMACY INC
Other - Org Name:LIMS FAMILY PHARMACY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:LIM
Authorized Official - Suffix:
Authorized Official - Credentials:CHPT
Authorized Official - Phone:530-241-8700
Mailing Address - Street 1:1035 PLACER ST
Mailing Address - Street 2:STE 110
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-1125
Mailing Address - Country:US
Mailing Address - Phone:530-241-8700
Mailing Address - Fax:530-241-8889
Practice Address - Street 1:1035 PLACER ST
Practice Address - Street 2:STE 110
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-1125
Practice Address - Country:US
Practice Address - Phone:530-241-8700
Practice Address - Fax:530-241-8889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
CAPHY454183336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1998037OtherPK
CAPHA454180Medicaid