Provider Demographics
NPI:1316420532
Name:MAI, THY KIM (PHARMD)
Entity type:Individual
Prefix:DR
First Name:THY
Middle Name:KIM
Last Name:MAI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:THY
Other - Middle Name:KIM
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:315 N 9TH ST
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63101-1460
Mailing Address - Country:US
Mailing Address - Phone:314-436-7491
Mailing Address - Fax:
Practice Address - Street 1:301 N 9TH ST
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63101-1460
Practice Address - Country:US
Practice Address - Phone:314-436-7491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-13
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019002087183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist