Provider Demographics
NPI:1114039864
Name:HAMPEL, JUSTIN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:
Last Name:HAMPEL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7741 N SHERMAN RD
Mailing Address - Street 2:
Mailing Address - City:BARRYTON
Mailing Address - State:MI
Mailing Address - Zip Code:49305-9606
Mailing Address - Country:US
Mailing Address - Phone:989-382-7064
Mailing Address - Fax:
Practice Address - Street 1:352 N ROSS ST
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:MI
Practice Address - Zip Code:48612-8165
Practice Address - Country:US
Practice Address - Phone:989-435-7727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302033854183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist