Provider Demographics
NPI:1528281003
Name:HINCKLEY, JOEL BRADFORD (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:BRADFORD
Last Name:HINCKLEY
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 1:669 AGENCY MAIN ST
Mailing Address - Street 2:PHARMACY DEPARTMENT
Mailing Address - City:HARLEM
Mailing Address - State:MT
Mailing Address - Zip Code:59526-9455
Mailing Address - Country:US
Mailing Address - Phone:406-353-3103
Mailing Address - Fax:406-353-3266
Practice Address - Street 1:669 AGENCY MAIN ST
Practice Address - Street 2:PHARMACY DEPARTMENT
Practice Address - City:HARLEM
Practice Address - State:MT
Practice Address - Zip Code:59526-9455
Practice Address - Country:US
Practice Address - Phone:406-353-3103
Practice Address - Fax:406-353-3266
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1518183500000X
MT4975183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist