Provider Demographics
NPI:1750336954
Name:RIMMER, RENEE S (OD)
Entity type:Individual
Prefix:DR
First Name:RENEE
Middle Name:S
Last Name:RIMMER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3831 E FIRST ST
Mailing Address - Street 2:
Mailing Address - City:BLUE RIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30513-4525
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3831 E FIRST ST
Practice Address - Street 2:
Practice Address - City:BLUE RIDGE
Practice Address - State:GA
Practice Address - Zip Code:30513-4525
Practice Address - Country:US
Practice Address - Phone:706-632-1995
Practice Address - Fax:706-632-9852
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2010-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT 001406152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000569511BMedicaid
GA41ZCFDXMedicare PIN
GAU44861Medicare UPIN