Provider Demographics
NPI:1124438049
Name:ZIMMER, JAMES ARTHUR JR (RPH)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ARTHUR
Last Name:ZIMMER
Suffix:JR
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 1:610 EGLIN PKWY NE
Mailing Address - Street 2:
Mailing Address - City:FORT WALTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32547-2832
Mailing Address - Country:US
Mailing Address - Phone:850-862-6185
Mailing Address - Fax:
Practice Address - Street 1:610 EGLIN PKWY NE
Practice Address - Street 2:
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32547-2832
Practice Address - Country:US
Practice Address - Phone:850-862-6185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-30
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS38132183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist