Provider Demographics
NPI:1811372519
Name:HINNENKAMP, MICHAEL (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:HINNENKAMP
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15051 E 104TH AVE
Mailing Address - Street 2:
Mailing Address - City:COMMERCE CITY
Mailing Address - State:CO
Mailing Address - Zip Code:80022-9706
Mailing Address - Country:US
Mailing Address - Phone:303-286-5470
Mailing Address - Fax:
Practice Address - Street 1:2750 S COLORADO BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-6602
Practice Address - Country:US
Practice Address - Phone:303-512-0449
Practice Address - Fax:303-512-0626
Is Sole Proprietor?:No
Enumeration Date:2015-07-23
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO20821183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist