Reynolds, Kim M
Reynolds, Kim M is an sole proprietor health care provider with primary practice located at 303 Main St , Massena NY 13662-1903. She recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as her primary health care specialty. Reynolds, Kim M can be contacted via phone (315) 764-0204.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Pharmacy Service Providers / Pharmacist | 183500000X | 042235 | New York |
Profile Details
| NPI number | 1205015864 |
|---|---|
| LBN Legal business name | Reynolds, Kim M |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 31st, 2007 |
| Last updated | Sep 8th, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1205015864 | NPPES |
| New York | MEDICAID | 02939004 |
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