Provider Demographics
NPI:1649872177
Name:RHYMER, KIM RUTH (DPH)
Entity type:Individual
Prefix:DR
First Name:KIM
Middle Name:RUTH
Last Name:RHYMER
Suffix:
Gender:F
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8316 JOHN ROBERT DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73135-6071
Mailing Address - Country:US
Mailing Address - Phone:405-919-1511
Mailing Address - Fax:
Practice Address - Street 1:324 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74801-7012
Practice Address - Country:US
Practice Address - Phone:405-273-7801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-10
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK15497183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist