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Organization
KIMS MODERN PHARMACY INC
Active
Organization
KIMS MODERN PHARMACY INC
Active
Other names
Modern Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NAMIL KIM (MANAGER)
(773) 588-6055
Entity
Organization
Contact information
Practice address
3432 W LAWRENCE AVE, CHICAGO, IL 60625-5117
(773) 588-6055
(773) 588-5005
Mailing address
3432 W LAWRENCE AVE, CHICAGO, IL 60625-5117
(773) 588-6055
(773) 588-5005
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
054006861
IL
3336C0003X
Community/Retail Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1440522
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/31/2006
Last updated
11/24/2008
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