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General NPI Number Information
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NPI Number | 1356262083
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Entity Type | Individual
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Provider Name | XANDER VAN HENDRICKSON PHARMD
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Gender | Male
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Dates
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Enumeration Date | 07/21/2026
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Last Update Date | 07/21/2026
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Provider Practice Location Address
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Address Line | 1225 PARIS RD
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City | MAYFIELD
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State | KY
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Zip | 42066-4989
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Country | US
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Telephone | 270-247-2280
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Fax | 270-247-2559
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Provider Business Mailing Address
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Address Line | 39 LALLA LN
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City | MAYFIELD
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State | KY
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Zip | 42066-4967
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Country | US
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Telephone | 270-705-5345
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 025884
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License Number State | KY
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