Provider Demographics
NPI:1558490920
Name:KRINKE, STEPHEN BERNARD (RPH)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:BERNARD
Last Name:KRINKE
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 1:4214 PERSIMMON WOODS DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508-8684
Mailing Address - Country:US
Mailing Address - Phone:304-594-3537
Mailing Address - Fax:
Practice Address - Street 1:4214 PERSIMMON WOODS DR
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508-8684
Practice Address - Country:US
Practice Address - Phone:304-594-3537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-10874183500000X
VA0202009869183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist