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NPI Code Detail

MEDICARE: MS. DEMETRIA BARNES HENDRIX RPH

MEDICARE: MS. DEMETRIA BARNES HENDRIX RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistRPH013745GA

General Provider Information

NPI Number : 1164420220
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DEMETRIA BARNES HENDRIX RPH
Provider Business Mailing Address
First Line : 213 LONGLEAF WAY
Second Line :
City : PINE MOUNTAIN
State : GA
Zip : 31822-2825
Country : US
Telephone Number : 706-663-9002
Fax Number :
Provider Business Practice Location Address
First Line : 2100 COMER AVE
Second Line : AMBULATORY CARE PHARMACY
City : COLUMBUS
State : GA
Zip : 31904-8725
Country : US
Telephone Number : 706-321-3779
Fax Number : 706-321-3751
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2005
Last Update Date : 10/23/2008

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