Healthcare Provider Details

I. General information

NPI: 1700300704
Provider Name (Legal Business Name): KIMBERLY MICHELLE RYMERS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2017
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9835 FALL CREEK RD
INDIANAPOLIS IN
46256-4802
US

IV. Provider business mailing address

9835 FALL CREEK RD
INDIANAPOLIS IN
46256-4802
US

V. Phone/Fax

Practice location:
  • Phone: 317-577-3486
  • Fax: 317-577-3487
Mailing address:
  • Phone: 317-577-3486
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number26029644A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number27187
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: