Provider Demographics
NPI:1316352354
Name:ELIA, RIMA
Entity type:Individual
Prefix:
First Name:RIMA
Middle Name:
Last Name:ELIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 CONSTANT ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-3810
Mailing Address - Country:US
Mailing Address - Phone:978-424-7746
Mailing Address - Fax:
Practice Address - Street 1:45 CONSTANT ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-3810
Practice Address - Country:US
Practice Address - Phone:978-424-7746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-28
Last Update Date:2014-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3589183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist