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General NPI Number Information
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NPI Number | 1942502661
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Entity Type | Individual
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Provider Name | DAVID IRA HENDRICKS PHARM D
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Gender | Male
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Dates
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Enumeration Date | 12/01/2010
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Last Update Date | 12/01/2010
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Provider Practice Location Address
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Address Line | 333 WEST MILLS STREET
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City | COLUMBUS
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State | NC
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Zip | 28722
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Country | US
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Telephone | 828-894-8247
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Fax | 828-894-3891
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Provider Business Mailing Address
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Address Line | 1 BROOK BROOK FOREST DRIVE
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City | ARDEN
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State | NC
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Zip | 28704
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Country | US
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Telephone | 828-676-0673
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Fax | 828-676-0673
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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 | 18027
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 57042
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2005011044
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0010718
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License Number State | OR
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