Provider Demographics
NPI:1184271041
Name:CARROLL, KIM YOUNG (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KIM
Middle Name:YOUNG
Last Name:CARROLL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MISS
Other - First Name:KIM
Other - Middle Name:YOUNG
Other - Last Name:PIERCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 69791
Mailing Address - Street 2:
Mailing Address - City:ORO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85737-0022
Mailing Address - Country:US
Mailing Address - Phone:520-820-5859
Mailing Address - Fax:
Practice Address - Street 1:2001 E IRVINGTON RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85714-1847
Practice Address - Country:US
Practice Address - Phone:520-294-7165
Practice Address - Fax:520-294-8625
Is Sole Proprietor?:No
Enumeration Date:2019-08-23
Last Update Date:2023-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZI023742390200000X
AZS026011183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program