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NPI Code Detail

MEDICARE: LEIGH HINES RPH

MEDICARE: LEIGH HINES RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistS019433AZ
21835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistS019433AZ

General Provider Information

NPI Number : 1356690853
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEIGH HINES RPH
Provider Business Mailing Address
First Line : 4265 E RAWHIDE ST
Second Line :
City : GILBERT
State : AZ
Zip : 85296-1570
Country : US
Telephone Number : 702-275-3493
Fax Number :
Provider Business Practice Location Address
First Line : 1775 LAKESIDE DR
Second Line :
City : BULLHEAD CITY
State : AZ
Zip : 86442-5732
Country : US
Telephone Number : 928-763-8686
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2012
Last Update Date : 04/28/2020

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Directions to “ LEIGH HINES RPH” Practice Location

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