Provider Demographics
NPI:1801220587
Name:KIME, MALORIE ANN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MALORIE
Middle Name:ANN
Last Name:KIME
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1540 28TH ST SE
Mailing Address - Street 2:PHARMACY
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49508-1412
Mailing Address - Country:US
Mailing Address - Phone:616-248-2610
Mailing Address - Fax:
Practice Address - Street 1:1540 28TH ST SE
Practice Address - Street 2:PHARMACY
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49508-1412
Practice Address - Country:US
Practice Address - Phone:616-248-2610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-29
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302039312183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist