Provider Demographics
NPI:1518243286
Name:DINKEL, CHARLES H (RPH)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:H
Last Name:DINKEL
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 1:1013 WYLDE OAK DR
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54904-7636
Mailing Address - Country:US
Mailing Address - Phone:920-426-4485
Mailing Address - Fax:
Practice Address - Street 1:925 W FULTON ST
Practice Address - Street 2:
Practice Address - City:WAUPACA
Practice Address - State:WI
Practice Address - Zip Code:54981-1479
Practice Address - Country:US
Practice Address - Phone:715-258-9228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-26
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI08754-040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist