Provider Demographics
NPI:1609110246
Name:HENDRIX BUILDING CONSULTANT AND SUPPLY
Entity Type:Organization
Organization Name:HENDRIX BUILDING CONSULTANT AND SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRYANT
Authorized Official - Middle Name:J
Authorized Official - Last Name:HENDRIX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-521-0076
Mailing Address - Street 1:603 NABOCHO RD
Mailing Address - Street 2:
Mailing Address - City:LAKIN
Mailing Address - State:KS
Mailing Address - Zip Code:67860-9455
Mailing Address - Country:US
Mailing Address - Phone:620-521-0076
Mailing Address - Fax:
Practice Address - Street 1:603 NABOCHO RD
Practice Address - Street 2:
Practice Address - City:LAKIN
Practice Address - State:KS
Practice Address - Zip Code:67860-9455
Practice Address - Country:US
Practice Address - Phone:620-521-0076
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-20
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty