Basic Information
| Provider Information | |||||||||
| NPI: | 1205049947 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PRIMEAU | ||||||||
| FirstName: | RITA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 234 SWOPES VALLEY RD | ||||||||
| Address2: | |||||||||
| City: | PINE GROVE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 179638808 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5703458710 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3030 CHESTNUT ST | ||||||||
| Address2: | |||||||||
| City: | LEBANON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170422518 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172738000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/08/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WA0400X | RN181697L | PA | Y | Nursing Service Providers | Registered Nurse | Addiction (Substance Use Disorder) |
No ID Information.