Healthcare Provider Details

I. General information

NPI: 1124785605
Provider Name (Legal Business Name): LEAH C HINKLE CPHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LEAH C. HINKLE LEAH C. HINKLE CPHT

II. Dates (important events)

Enumeration Date: 11/19/2021
Last Update Date: 11/19/2021
Certification Date: 11/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4910 E ASHLAN AVE STE 111
FRESNO CA
93726-3021
US

IV. Provider business mailing address

4910 E ASHLAN AVE STE 111
FRESNO CA
93726-3021
US

V. Phone/Fax

Practice location:
  • Phone: 800-499-9079
  • Fax: 800-237-1256
Mailing address:
  • Phone: 800-499-9079
  • Fax: 800-237-1256

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number153053
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: