Provider Demographics
NPI:1285914838
Name:HINES, JEFFREY GENE (PHARMD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:GENE
Last Name:HINES
Suffix:
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 1:6545 STONEBROOK PKWY
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68521-6659
Mailing Address - Country:US
Mailing Address - Phone:402-742-6820
Mailing Address - Fax:
Practice Address - Street 1:5730 R ST
Practice Address - Street 2:SUITE E
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68505-2309
Practice Address - Country:US
Practice Address - Phone:402-464-4800
Practice Address - Fax:402-464-8571
Is Sole Proprietor?:No
Enumeration Date:2011-08-26
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE9507183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist