Provider Demographics
NPI:1255641577
Name:REBMANN, CAMI LYN (PHARM D)
Entity type:Individual
Prefix:DR
First Name:CAMI
Middle Name:LYN
Last Name:REBMANN
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 1:5125 S WHITLEY
Mailing Address - Street 2:
Mailing Address - City:FRUITLAND
Mailing Address - State:ID
Mailing Address - Zip Code:83619
Mailing Address - Country:US
Mailing Address - Phone:208-241-3257
Mailing Address - Fax:
Practice Address - Street 1:728 S 4TH AVE
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:OR
Practice Address - Zip Code:97914
Practice Address - Country:US
Practice Address - Phone:541-889-3390
Practice Address - Fax:541-889-4488
Is Sole Proprietor?:No
Enumeration Date:2010-10-20
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR011855183500000X
IDP6291183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist