Provider Demographics
NPI:1740886068
Name:RINN, KEVIN LAWRENCE (RPH)
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:LAWRENCE
Last Name:RINN
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 1:233 S MANSE AVE
Mailing Address - Street 2:
Mailing Address - City:GIDDINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78942-3440
Mailing Address - Country:US
Mailing Address - Phone:254-541-1292
Mailing Address - Fax:
Practice Address - Street 1:233 S MANSE AVE
Practice Address - Street 2:
Practice Address - City:GIDDINGS
Practice Address - State:TX
Practice Address - Zip Code:78942-3440
Practice Address - Country:US
Practice Address - Phone:979-542-3164
Practice Address - Fax:979-542-3489
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29955183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist