Provider Demographics
NPI:1942536974
Name:LOUI, JIM K (RPH)
Entity Type:Individual
Prefix:
First Name:JIM
Middle Name:K
Last Name:LOUI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6146 E 14TH AVE
Mailing Address - Street 2:
Mailing Address - City:APACHE JUNCTION
Mailing Address - State:AZ
Mailing Address - Zip Code:85119-9372
Mailing Address - Country:US
Mailing Address - Phone:480-982-7440
Mailing Address - Fax:
Practice Address - Street 1:4440 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85205-7902
Practice Address - Country:US
Practice Address - Phone:480-218-8573
Practice Address - Fax:480-218-8567
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-27
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6257183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist