Healthcare Provider Details

I. General information

NPI: 1295333003
Provider Name (Legal Business Name): JOYCE SHREVES RIMMER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2020
Last Update Date: 10/14/2020
Certification Date: 10/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4025 WINDER HWY
FLOWERY BRANCH GA
30542-3022
US

IV. Provider business mailing address

4032 WALKERS RIDGE CT
DACULA GA
30019-4630
US

V. Phone/Fax

Practice location:
  • Phone: 770-539-5030
  • Fax: 770-539-5949
Mailing address:
  • Phone: 404-316-0648
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number17178
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: