Provider Demographics
NPI:1417514399
Name:RIM, KYUNG (PHARMD)
Entity Type:Individual
Prefix:
First Name:KYUNG
Middle Name:
Last Name:RIM
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:690 S PORTER ST APT 30
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-3194
Mailing Address - Country:US
Mailing Address - Phone:802-881-3913
Mailing Address - Fax:
Practice Address - Street 1:620 LAFAYETTE RD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:NH
Practice Address - Zip Code:03842-3358
Practice Address - Country:US
Practice Address - Phone:603-929-1258
Practice Address - Fax:603-929-9238
Is Sole Proprietor?:No
Enumeration Date:2019-05-25
Last Update Date:2019-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHPHCY-04453183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist