Provider Demographics
NPI:1528203254
Name:RAIMAN, JOEL H (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOEL
Middle Name:H
Last Name:RAIMAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:MR
Other - First Name:JOEL
Other - Middle Name:H
Other - Last Name:RAIMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMACIST
Mailing Address - Street 1:2901 BERNARDO LN
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-4054
Mailing Address - Country:US
Mailing Address - Phone:702-630-4082
Mailing Address - Fax:702-630-4082
Practice Address - Street 1:2901 BERNARDO LN
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-4054
Practice Address - Country:US
Practice Address - Phone:702-630-4082
Practice Address - Fax:702-630-4082
Is Sole Proprietor?:No
Enumeration Date:2008-12-09
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV105021835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy