Provider Demographics
NPI:1699801225
Name:VANPOPERING, JOHN ALLEN (RPH)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:ALLEN
Last Name:VANPOPERING
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 1:12359 MCCLELLAND AVE
Mailing Address - Street 2:
Mailing Address - City:GRANT
Mailing Address - State:MI
Mailing Address - Zip Code:49327-8980
Mailing Address - Country:US
Mailing Address - Phone:231-834-1927
Mailing Address - Fax:
Practice Address - Street 1:11 E DIVISION ST
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:MI
Practice Address - Zip Code:49345-1325
Practice Address - Country:US
Practice Address - Phone:616-887-0600
Practice Address - Fax:616-887-5361
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302030102183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist