Healthcare Provider Details

I. General information

NPI: 1447490198
Provider Name (Legal Business Name): LARAINE RIMKO PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2009
Last Update Date: 02/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2152 REID AVE
LORAIN OH
44052-4722
US

IV. Provider business mailing address

2152 REID AVE
LORAIN OH
44052-4722
US

V. Phone/Fax

Practice location:
  • Phone: 440-244-1677
  • Fax: 440-244-1679
Mailing address:
  • Phone: 440-244-1677
  • Fax: 440-244-1679

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License NumberRCP.2245
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number50.001048
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: