Provider Demographics
NPI:1902210479
Name:SINLEY, RANDY LEE (RPH)
Entity Type:Individual
Prefix:MR
First Name:RANDY
Middle Name:LEE
Last Name:SINLEY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21087 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BUCKEYE
Mailing Address - State:AZ
Mailing Address - Zip Code:85396-3500
Mailing Address - Country:US
Mailing Address - Phone:623-853-2113
Mailing Address - Fax:623-853-2119
Practice Address - Street 1:21087 W MAIN ST
Practice Address - Street 2:
Practice Address - City:BUCKEYE
Practice Address - State:AZ
Practice Address - Zip Code:85396-3500
Practice Address - Country:US
Practice Address - Phone:623-853-2113
Practice Address - Fax:623-853-2119
Is Sole Proprietor?:No
Enumeration Date:2014-06-12
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS014486183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist