Provider Demographics
NPI:1144524000
Name:SOMERS, KIM S (RPH)
Entity type:Individual
Prefix:
First Name:KIM
Middle Name:S
Last Name:SOMERS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2336 CHAPPELL RD
Mailing Address - Street 2:
Mailing Address - City:HAMPTONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27020-7124
Mailing Address - Country:US
Mailing Address - Phone:336-468-4732
Mailing Address - Fax:
Practice Address - Street 1:1127 N BRIDGE ST
Practice Address - Street 2:
Practice Address - City:ELKIN
Practice Address - State:NC
Practice Address - Zip Code:28621-2407
Practice Address - Country:US
Practice Address - Phone:336-835-3529
Practice Address - Fax:336-835-6508
Is Sole Proprietor?:No
Enumeration Date:2011-01-06
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9088183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist