Provider Demographics
NPI:1851977839
Name:HENDRIX, RICK
Entity Type:Individual
Prefix:
First Name:RICK
Middle Name:
Last Name:HENDRIX
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5734 JULIA KATE DR
Mailing Address - Street 2:
Mailing Address - City:MORROW
Mailing Address - State:OH
Mailing Address - Zip Code:45152-8665
Mailing Address - Country:US
Mailing Address - Phone:513-313-0538
Mailing Address - Fax:
Practice Address - Street 1:5734 JULIA KATE DR
Practice Address - Street 2:
Practice Address - City:MORROW
Practice Address - State:OH
Practice Address - Zip Code:45152-8665
Practice Address - Country:US
Practice Address - Phone:513-313-0538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-22
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03219531183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist