Provider Demographics
NPI:1831659176
Name:REMBERT, KALIMA E (PP)
Entity Type:Individual
Prefix:MISS
First Name:KALIMA
Middle Name:E
Last Name:REMBERT
Suffix:
Gender:F
Credentials:PP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 LEE ROAD 2126
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:AL
Mailing Address - Zip Code:36874-2161
Mailing Address - Country:US
Mailing Address - Phone:334-332-9278
Mailing Address - Fax:
Practice Address - Street 1:200 LEE ROAD 2126
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:AL
Practice Address - Zip Code:36874-2161
Practice Address - Country:US
Practice Address - Phone:334-332-9278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-22
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor