Provider Demographics
NPI:1366837072
Name:RINKER, JOHN TYLER
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:TYLER
Last Name:RINKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10472 DUNCANNON TRL
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-1201
Mailing Address - Country:US
Mailing Address - Phone:407-256-2723
Mailing Address - Fax:
Practice Address - Street 1:10472 DUNCANNON TRL
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-1201
Practice Address - Country:US
Practice Address - Phone:407-256-2723
Practice Address - Fax:407-256-2723
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS10807390200000X
AL19344183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty