Provider Demographics
NPI:1487273629
Name:PAPINEAU, JON HENRY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JON
Middle Name:HENRY
Last Name:PAPINEAU
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 STURDY RD
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-4126
Mailing Address - Country:US
Mailing Address - Phone:219-462-7173
Mailing Address - Fax:
Practice Address - Street 1:1001 STURDY RD
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-4126
Practice Address - Country:US
Practice Address - Phone:219-462-7173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-08
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26028171A1835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care