Provider Demographics
NPI:1710262324
Name:BRINKRUFF, STEPHEN DOWE (RPH)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:DOWE
Last Name:BRINKRUFF
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 1:8281 COURTNEY DR
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-4418
Mailing Address - Country:US
Mailing Address - Phone:317-432-1110
Mailing Address - Fax:
Practice Address - Street 1:11020 PENDLETON PIKE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46236-2817
Practice Address - Country:US
Practice Address - Phone:317-826-3903
Practice Address - Fax:317-826-4515
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-14
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26021300A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist