Provider Demographics
NPI:1831474352
Name:EL TERK, RIMA
Entity Type:Individual
Prefix:DR
First Name:RIMA
Middle Name:
Last Name:EL TERK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27015 HEATHERFORD DR APT 3
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-2675
Mailing Address - Country:US
Mailing Address - Phone:419-873-5418
Mailing Address - Fax:
Practice Address - Street 1:27015 HEATHERFORD DR APT 3
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-2675
Practice Address - Country:US
Practice Address - Phone:419-873-5418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-16
Last Update Date:2011-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-27403183500000X
MI5302036808183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist