Provider Demographics
NPI:1851987754
Name:KIM, APRIL S
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:S
Last Name:KIM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1117 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4965
Mailing Address - Country:US
Mailing Address - Phone:215-627-2143
Mailing Address - Fax:215-627-8943
Practice Address - Street 1:1117 WALNUT ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4965
Practice Address - Country:US
Practice Address - Phone:215-627-2143
Practice Address - Fax:215-627-8943
Is Sole Proprietor?:No
Enumeration Date:2020-12-15
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP451866183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist