Provider Demographics
NPI:1588197222
Name:HENDRIX, WENDI JENNINGS (RPH)
Entity Type:Individual
Prefix:
First Name:WENDI
Middle Name:JENNINGS
Last Name:HENDRIX
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:964 GI MADDOX PKWY
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30705-4000
Mailing Address - Country:US
Mailing Address - Phone:706-517-7312
Mailing Address - Fax:706-517-7341
Practice Address - Street 1:964 GI MADDOX PKWY
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:GA
Practice Address - Zip Code:30705-4000
Practice Address - Country:US
Practice Address - Phone:706-517-7312
Practice Address - Fax:706-517-7341
Is Sole Proprietor?:No
Enumeration Date:2017-04-10
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH016661183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist