Provider Demographics
NPI:1396843975
Name:KUNZ, JAMES J (RPH)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:J
Last Name:KUNZ
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 1:324 SUPERIOR AVENUE
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL FALLS
Mailing Address - State:MI
Mailing Address - Zip Code:49920-1427
Mailing Address - Country:US
Mailing Address - Phone:906-875-6781
Mailing Address - Fax:906-875-6781
Practice Address - Street 1:324 SUPERIOR AVENUE
Practice Address - Street 2:
Practice Address - City:CRYSTAL FALLS
Practice Address - State:MI
Practice Address - Zip Code:49920-1427
Practice Address - Country:US
Practice Address - Phone:906-875-6781
Practice Address - Fax:906-875-6781
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5301004473183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2341179Medicaid
MI1246680001Medicare ID - Type Unspecified