Provider Demographics
NPI:1851570873
Name:RIMKUNAS, JOAN VICTORIA (RPH)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:VICTORIA
Last Name:RIMKUNAS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 N MAIN ST
Mailing Address - Street 2:PO BOX 449
Mailing Address - City:NORTHVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12134-3550
Mailing Address - Country:US
Mailing Address - Phone:518-863-6524
Mailing Address - Fax:518-863-6546
Practice Address - Street 1:212 N MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTHVILLE
Practice Address - State:NY
Practice Address - Zip Code:12134-3550
Practice Address - Country:US
Practice Address - Phone:518-863-6524
Practice Address - Fax:518-863-6546
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-25
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038163183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist