Provider Demographics
NPI:1083997191
Name:ZIMMERMAN, RAMONA JUNE (RPH)
Entity Type:Individual
Prefix:MS
First Name:RAMONA
Middle Name:JUNE
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MRS
Other - First Name:RAMONA
Other - Middle Name:JUNE
Other - Last Name:SPARLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:378 BALDWIN ST
Mailing Address - Street 2:
Mailing Address - City:JENISON
Mailing Address - State:MI
Mailing Address - Zip Code:49428-7909
Mailing Address - Country:US
Mailing Address - Phone:616-667-8695
Mailing Address - Fax:
Practice Address - Street 1:378 BALDWIN ST
Practice Address - Street 2:
Practice Address - City:JENISON
Practice Address - State:MI
Practice Address - Zip Code:49428-7909
Practice Address - Country:US
Practice Address - Phone:616-667-8695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-25
Last Update Date:2011-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302028503183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist