Provider Demographics
NPI:1144375601
Name:TINKLENBERG, JAMES FREDERICK (RPH)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:FREDERICK
Last Name:TINKLENBERG
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1106 HAZEL ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH HAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:49090-1660
Mailing Address - Country:US
Mailing Address - Phone:269-639-7188
Mailing Address - Fax:
Practice Address - Street 1:08337 M-140
Practice Address - Street 2:UNIT #2
Practice Address - City:SOUTH HAVEN
Practice Address - State:MI
Practice Address - Zip Code:49090-1660
Practice Address - Country:US
Practice Address - Phone:269-637-3222
Practice Address - Fax:269-637-4089
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302031265183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist