Provider Demographics
NPI:1295545986
Name:KIMBER, JIMMY (PHARMD)
Entity type:Individual
Prefix:
First Name:JIMMY
Middle Name:
Last Name:KIMBER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 WELLNESS PL APT 1926
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89011-2349
Mailing Address - Country:US
Mailing Address - Phone:901-319-0651
Mailing Address - Fax:
Practice Address - Street 1:701 SHADOW LN
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4131
Practice Address - Country:US
Practice Address - Phone:877-480-1755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV24337183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist