Organization
PRO KIMA, LLC
Active
Organization
PRO KIMA, LLC
Active
Other names
VIP Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
PEYMAN KIMASI (OFFICER)
(503) 975-0925
Entity
Organization
Contact information
Practice address
1891 N LEE TREVINO DR STE 200, EL PASO, TX 79936-4132
(915) 629-2020
Mailing address
1891 N LEE TREVINO DR, # 200, EL PASO, TX 79936-4127
(915) 629-2020
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
29737
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2149871
PK
—
Enumeration date
02/03/2015
Last updated
02/03/2015
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