Provider Demographics
NPI:1871688382
Name:ZIMARDO, JOSEPH MATTHEW (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:MATTHEW
Last Name:ZIMARDO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 PRIMROSE LANE EAST
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-8895
Mailing Address - Country:US
Mailing Address - Phone:717-741-4483
Mailing Address - Fax:
Practice Address - Street 1:2727 PRIMROSE LANE EAST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-8895
Practice Address - Country:US
Practice Address - Phone:717-741-4483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP036956L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist