Provider Demographics
NPI:1083157911
Name:HENDRIX, SARAH MARIE (CPHT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MARIE
Last Name:HENDRIX
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4168 ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:CHEBOYGAN
Mailing Address - State:MI
Mailing Address - Zip Code:49721-8634
Mailing Address - Country:US
Mailing Address - Phone:231-420-2279
Mailing Address - Fax:231-627-8294
Practice Address - Street 1:127 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CHEBOYGAN
Practice Address - State:MI
Practice Address - Zip Code:49721-1637
Practice Address - Country:US
Practice Address - Phone:231-627-9949
Practice Address - Fax:231-627-8294
Is Sole Proprietor?:No
Enumeration Date:2016-11-26
Last Update Date:2016-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5303008705183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician