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General NPI Number Information
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NPI Number | 1700166311
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Entity Type | Individual
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Provider Name | ASA CLARK HINKLEY PHARM D
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Gender | Male
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Dates
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Enumeration Date | 08/26/2011
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Last Update Date | 08/26/2011
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Provider Practice Location Address
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Address Line | 2839 COUNTY ROAD 210 W
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City | JACKSONVILLE
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State | FL
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Zip | 32259-2016
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Country | US
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Telephone | 904-287-5476
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Fax | 904-287-8442
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Provider Business Mailing Address
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Address Line | 5988 SHADEHILL RD
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City | JACKSONVILLE
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State | FL
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Zip | 32258-5192
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Country | US
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Telephone | 904-262-3302
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Fax | 904-287-8442
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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 | PS37139
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License Number State | FL
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