Jack Kim

Pharmacist · Maplewood, MN

Individual Active NPI

NPI number 1770264103

Practice location

100 County Road B W
Maplewood, MN 55117-1931
Phone
(608) 772-8773

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NPI record

NPI
1770264103
Entity type
Individual (Type 1)
Enumeration date
July 27, 2023
Last updated
August 28, 2024
Certified
August 28, 2024
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Pharmacist Primary 183500000X 126132 MN
Pharmacist 183500000X PH-4988 HI
Pharmacist 183500000X 22263 WI

About Jack Kim

Jack Kim is a healthcare provider registered in the NPI registry with the primary taxonomy Pharmacist (code 183500000X). The practice location is 100 County Road B W, Maplewood, MN 55117-1931. The NPI number 1770264103 was assigned on July 27, 2023 and the record was last updated on August 28, 2024.

Jack Kim lists 3 licenses in the registry: #126132 (MN) for Pharmacist; #PH-4988 (HI) for Pharmacist; #22263 (WI) for Pharmacist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Jack Kim?

The NPI number is 1770264103.

What is the phone number of Jack Kim?

The phone number listed for the practice location is (608) 772-8773.

Where is Jack Kim located?

100 County Road B W, Maplewood, MN 55117-1931.

What is the taxonomy code for Jack Kim?

The primary taxonomy code is 183500000X – Pharmacist; 2 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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