Provider Demographics
NPI:1528376290
Name:HINCHER, SANDRA WELBORN (BS)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:WELBORN
Last Name:HINCHER
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 5TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKINGS
Mailing Address - State:OR
Mailing Address - Zip Code:97415-9658
Mailing Address - Country:US
Mailing Address - Phone:547-463-1943
Mailing Address - Fax:541-469-1637
Practice Address - Street 1:325 5TH ST
Practice Address - Street 2:
Practice Address - City:BROOKINGS
Practice Address - State:OR
Practice Address - Zip Code:97415-9658
Practice Address - Country:US
Practice Address - Phone:252-638-2600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-15
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8166183500000X
ORORRPH00142411835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist