Healthcare Provider Details

I. General information

NPI: 1467453191
Provider Name (Legal Business Name): JOHN FORRY HINKLE III RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/03/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

261 LOCUST ST
COLUMBIA PA
17512-1110
US

IV. Provider business mailing address

144 COOPER AVE
LANDISVILLE PA
17538-1252
US

V. Phone/Fax

Practice location:
  • Phone: 717-684-2551
  • Fax: 717-684-6239
Mailing address:
  • Phone: 717-898-5728
  • Fax: 717-684-6239

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP037441L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: