Provider Demographics
NPI:1669149886
Name:JARJOUR, RIM (PHARMACY)
Entity type:Individual
Prefix:
First Name:RIM
Middle Name:
Last Name:JARJOUR
Suffix:
Gender:F
Credentials:PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5614 TRUITT FARM CT
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20120-5406
Mailing Address - Country:US
Mailing Address - Phone:434-249-6758
Mailing Address - Fax:
Practice Address - Street 1:5614 TRUITT FARM CT
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20120-5406
Practice Address - Country:US
Practice Address - Phone:434-249-6758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-25
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202204417183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist