Provider Demographics
NPI:1750725941
Name:JOSE, MARIVIC RIMAS (PHARM D)
Entity type:Individual
Prefix:
First Name:MARIVIC
Middle Name:RIMAS
Last Name:JOSE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12959 S PARKER RD
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-3447
Mailing Address - Country:US
Mailing Address - Phone:303-840-7683
Mailing Address - Fax:303-805-5200
Practice Address - Street 1:12959 S PARKER RD
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-3447
Practice Address - Country:US
Practice Address - Phone:303-840-7683
Practice Address - Fax:303-805-5200
Is Sole Proprietor?:No
Enumeration Date:2013-04-18
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO17842183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist