Provider Demographics
NPI:1396044004
Name:VANHULLE, JAMES D (RPH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:D
Last Name:VANHULLE
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 1:305 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:CASSOPOLIS
Mailing Address - State:MI
Mailing Address - Zip Code:49031-1328
Mailing Address - Country:US
Mailing Address - Phone:269-445-5369
Mailing Address - Fax:269-445-0702
Practice Address - Street 1:305 E STATE ST
Practice Address - Street 2:
Practice Address - City:CASSOPOLIS
Practice Address - State:MI
Practice Address - Zip Code:49031-1328
Practice Address - Country:US
Practice Address - Phone:269-445-5369
Practice Address - Fax:269-445-0702
Is Sole Proprietor?:No
Enumeration Date:2011-03-21
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302025917183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist