Provider Demographics
NPI:1215238217
Name:RIMOV, PAUL A (RPH)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:A
Last Name:RIMOV
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4655 TORREY PINES DR
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-9295
Mailing Address - Country:US
Mailing Address - Phone:541-601-5253
Mailing Address - Fax:
Practice Address - Street 1:1003 MEDFORD CTR
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-6769
Practice Address - Country:US
Practice Address - Phone:541-608-3686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-06
Last Update Date:2010-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR8125183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist