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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

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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