Provider Demographics
NPI:1063169969
Name:KIM, MOONHEE (PHARMACIST)
Entity type:Individual
Prefix:DR
First Name:MOONHEE
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101-905 KUMHO BESTVILLE, JAMWON-DONG, SEOCHO-KU
Mailing Address - Street 2:
Mailing Address - City:SEOUL
Mailing Address - State:SEOUL
Mailing Address - Zip Code:137030
Mailing Address - Country:KR
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101-905 KUMHO BESTVILLE, JAMWON-DONG, SEOCHO-KU
Practice Address - Street 2:
Practice Address - City:SEOUL
Practice Address - State:SEOUL
Practice Address - Zip Code:137030
Practice Address - Country:KR
Practice Address - Phone:315-737-3597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH670021835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARPH67002OtherPRIVATE