Provider Demographics
NPI:1730365487
Name:KIM, HELENA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:HELENA
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4512 S DAKOTA AVE NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-2752
Mailing Address - Country:US
Mailing Address - Phone:410-636-9500
Mailing Address - Fax:410-636-9706
Practice Address - Street 1:803 BARKWOOD CT STE A
Practice Address - Street 2:
Practice Address - City:LINTHICUM
Practice Address - State:MD
Practice Address - Zip Code:21090-1426
Practice Address - Country:US
Practice Address - Phone:410-636-9500
Practice Address - Fax:410-636-9706
Is Sole Proprietor?:No
Enumeration Date:2008-01-11
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16473183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist