Healthcare Provider Details

I. General information

NPI: 1275818973
Provider Name (Legal Business Name): MS. MADELEINE HEYNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2011
Last Update Date: 10/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 MARKET ST
CAMP HILL PA
17011-4421
US

IV. Provider business mailing address

3200 MARKET ST
CAMP HILL PA
17011-4421
US

V. Phone/Fax

Practice location:
  • Phone: 717-763-1181
  • Fax: 717-763-4125
Mailing address:
  • Phone: 717-763-1181
  • Fax: 717-763-4125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP442148
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: