Provider Demographics
NPI:1114208709
Name:ZIMMER, ARNOLD JEFFERY (RPH)
Entity Type:Individual
Prefix:
First Name:ARNOLD
Middle Name:JEFFERY
Last Name:ZIMMER
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 1:110 WICOMICO TURN
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN
Mailing Address - State:VA
Mailing Address - Zip Code:23693-2614
Mailing Address - Country:US
Mailing Address - Phone:757-867-7757
Mailing Address - Fax:
Practice Address - Street 1:110 WICOMICO TURN
Practice Address - Street 2:
Practice Address - City:YORKTOWN
Practice Address - State:VA
Practice Address - Zip Code:23693-2614
Practice Address - Country:US
Practice Address - Phone:757-867-7757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202010193183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist