Provider Demographics
NPI:1922417815
Name:HINES, ANDRE PIERRE II (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:ANDRE
Middle Name:PIERRE
Last Name:HINES
Suffix:II
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14200 E ELLSWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-1402
Mailing Address - Country:US
Mailing Address - Phone:303-214-0115
Mailing Address - Fax:
Practice Address - Street 1:14200 E ELLSWORTH AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-1402
Practice Address - Country:US
Practice Address - Phone:303-214-0115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-05
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO20406183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist