1679980460 NPI number — WENDY HINCHCLIFF PHARMD

Table of content: WENDY HINCHCLIFF PHARMD (NPI 1679980460)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679980460 NPI number — WENDY HINCHCLIFF PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HINCHCLIFF
Provider First Name:
WENDY
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DYCK
Provider Other First Name:
WENDY
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1679980460
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/26/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1515 WEST BELL STREET
Provider Second Line Business Mailing Address:
SUITE 15
Provider Business Mailing Address City Name:
GLENDIVE
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59330
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-685-4282
Provider Business Mailing Address Fax Number:
360-685-4283

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1515 WEST BELL STREET
Provider Second Line Business Practice Location Address:
SUITE 15
Provider Business Practice Location Address City Name:
GLENDIVE
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59330
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-345-5336
Provider Business Practice Location Address Fax Number:
855-532-5430
Provider Enumeration Date:
07/14/2014

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  PHA-PHA-LIC-98439 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 183500000X , with the licence number: PH60027082 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: PH60027082 . This is a "WASHINGTON STATE PHARMACIST LICENSE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com