Provider Demographics
NPI:1770184442
Name:LIM, GINGER LEE (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:GINGER
Middle Name:LEE
Last Name:LIM
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8320 OLD KEENE MILL RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22152-1640
Mailing Address - Country:US
Mailing Address - Phone:703-569-6866
Mailing Address - Fax:
Practice Address - Street 1:8320 OLD KEENE MILL RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22152-1640
Practice Address - Country:US
Practice Address - Phone:703-569-6866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-07
Last Update Date:2020-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202010149183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist