Provider Demographics
NPI:1053639112
Name:GINN, CINDY R (RPH)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:R
Last Name:GINN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:577 MAST RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03102-1157
Mailing Address - Country:US
Mailing Address - Phone:603-623-3290
Mailing Address - Fax:603-623-2161
Practice Address - Street 1:577 MAST RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-1157
Practice Address - Country:US
Practice Address - Phone:603-623-3290
Practice Address - Fax:603-623-2161
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-13
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHR722183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist