Provider Demographics
NPI:1558796433
Name:RIMTEPATHIP, PAUN P (PHARMD)
Entity Type:Individual
Prefix:
First Name:PAUN
Middle Name:P
Last Name:RIMTEPATHIP
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5326 WHITEHAVEN PARK LN SE
Mailing Address - Street 2:
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-5954
Mailing Address - Country:US
Mailing Address - Phone:678-428-4271
Mailing Address - Fax:
Practice Address - Street 1:5015 FLOYD RD SW
Practice Address - Street 2:
Practice Address - City:MABLETON
Practice Address - State:GA
Practice Address - Zip Code:30126-1673
Practice Address - Country:US
Practice Address - Phone:770-819-5430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-10
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH026753183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist