Provider Demographics
NPI:1457178683
Name:KHABBAZ, RIMA A (RPH)
Entity type:Individual
Prefix:MRS
First Name:RIMA
Middle Name:A
Last Name:KHABBAZ
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 1:61 LOCUST ST APT 412
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-5933
Mailing Address - Country:US
Mailing Address - Phone:702-772-0718
Mailing Address - Fax:
Practice Address - Street 1:590 FELLSWAY
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-4925
Practice Address - Country:US
Practice Address - Phone:781-391-2668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH997177183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist