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General NPI Number Information
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NPI Number | 1326176439
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Entity Type | Organization
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Legal Business Name | HENDRIX HEALTH CENTER PHARMACY
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1104 7TH AVE S
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City | MOORHEAD
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State | MN
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Zip | 56563-0001
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Country | US
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Telephone | 218-477-5875
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Fax | 218-477-5855
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Provider Business Mailing Address
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Address Line | 1104 7TH AVE S # 92
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City | MOORHEAD
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State | MN
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Zip | 56563-0001
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Country | US
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Telephone | 218-477-5875
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Fax | 218-477-5855
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | ANDREA STENGL
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Credential | PHARM.D.
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Telephone | 218-477-5875
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 1170599
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License Number State | MN
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