Provider Demographics
NPI:1447490198
Name:RIMKO, LARAINE (PA-C)
Entity type:Individual
Prefix:
First Name:LARAINE
Middle Name:
Last Name:RIMKO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2152 REID AVE
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44052-4722
Mailing Address - Country:US
Mailing Address - Phone:440-244-1677
Mailing Address - Fax:440-244-1679
Practice Address - Street 1:2152 REID AVE
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44052-4722
Practice Address - Country:US
Practice Address - Phone:440-244-1677
Practice Address - Fax:440-244-1679
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-20
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRCP.2245227800000X
OH50.001048363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified