Provider Demographics
NPI:1033441225
Name:KIMBALL, JAMES STERLING (RPH)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:STERLING
Last Name:KIMBALL
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 1:1145 N BELSAY RD
Mailing Address - Street 2:
Mailing Address - City:BURTON
Mailing Address - State:MI
Mailing Address - Zip Code:48509-1653
Mailing Address - Country:US
Mailing Address - Phone:810-744-3820
Mailing Address - Fax:
Practice Address - Street 1:1145 N BELSAY RD
Practice Address - Street 2:
Practice Address - City:BURTON
Practice Address - State:MI
Practice Address - Zip Code:48509-1653
Practice Address - Country:US
Practice Address - Phone:810-744-3820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-12
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302021601183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist