Provider Demographics
NPI:1801114962
Name:HENDRIX, JENNIFER SPENCER
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:SPENCER
Last Name:HENDRIX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 PINEY WOODS LN
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:AL
Mailing Address - Zip Code:35080-8609
Mailing Address - Country:US
Mailing Address - Phone:205-664-9604
Mailing Address - Fax:
Practice Address - Street 1:2101 PELHAM PKWY
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-1116
Practice Address - Country:US
Practice Address - Phone:205-985-4995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14828183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist