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General NPI Number Information
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NPI Number | 1699801225
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Entity Type | Individual
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Provider Name | JOHN ALLEN VANPOPERING R.PH.
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Gender | Male
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 11 E DIVISION ST
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City | SPARTA
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State | MI
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Zip | 49345-1325
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Country | US
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Telephone | 616-887-0600
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Fax | 616-887-5361
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Provider Business Mailing Address
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Address Line | 12359 MCCLELLAND AVE
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City | GRANT
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State | MI
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Zip | 49327-8980
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Country | US
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Telephone | 231-834-1927
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5302030102
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License Number State | MI
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