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General NPI Number Information
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NPI Number | 1063769347
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Entity Type | Individual
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Provider Name | MARLA WINSTEAD KINKLE RPH
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Gender | Female
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Dates
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Enumeration Date | 08/06/2012
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Last Update Date | 06/15/2017
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Provider Practice Location Address
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Address Line | 1704 E GREENVILLE ST
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City | ANDERSON
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State | SC
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Zip | 29621-7914
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Country | US
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Telephone | 864-375-9401
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Fax | 864-231-9358
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Provider Business Mailing Address
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Address Line | 1900 N MAIN ST
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City | ANDERSON
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State | SC
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Zip | 29621-7914
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Country | US
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Telephone | 864-375-9401
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Fax | 864-231-9358
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 11663
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 18380
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License Number State | GA
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