Provider Demographics
NPI:1043423015
Name:WEINENGER, DARRELL HOWARD (RPH)
Entity Type:Individual
Prefix:MR
First Name:DARRELL
Middle Name:HOWARD
Last Name:WEINENGER
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 1:32305 MIDDLEBELT RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-1718
Mailing Address - Country:US
Mailing Address - Phone:248-486-0720
Mailing Address - Fax:248-486-3920
Practice Address - Street 1:56270 GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:NEW HUDSON
Practice Address - State:MI
Practice Address - Zip Code:48165-9727
Practice Address - Country:US
Practice Address - Phone:248-486-0720
Practice Address - Fax:248-486-3920
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302024105183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist