Provider Demographics
NPI:1205432754
Name:INGLE, TYLER (PHARMD, RPH)
Entity type:Individual
Prefix:DR
First Name:TYLER
Middle Name:
Last Name:INGLE
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 1:555 ENGLEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-2830
Mailing Address - Country:US
Mailing Address - Phone:513-519-9784
Mailing Address - Fax:401-652-9902
Practice Address - Street 1:555 ENGLEWOOD AVE
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-2830
Practice Address - Country:US
Practice Address - Phone:513-519-9784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03132027183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist