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NPI Code Detail

MEDICARE: AMANDA HENDRICKS PHARM.D.

MEDICARE: AMANDA HENDRICKS PHARM.D.
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
1183500000XPharmacistE-14039MS

General Provider Information

NPI Number : 1851775126
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA HENDRICKS PHARM.D.
Provider Business Mailing Address
First Line : 1606 HIGHLAND COLONY PKWY
Second Line :
City : MADISON
State : MS
Zip : 39110-6917
Country : US
Telephone Number : 601-605-5928
Fax Number :
Provider Business Practice Location Address
First Line : 1606 HIGHLAND COLONY PKWY
Second Line :
City : MADISON
State : MS
Zip : 39110-6917
Country : US
Telephone Number : 601-605-5928
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2015
Last Update Date : 07/16/2015

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