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NPI Code Detail

MEDICARE: JEFF HENDRICKS PHARMD

MEDICARE: JEFF HENDRICKS PHARMD
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
1183500000XPharmacist26026164AIN

General Provider Information

NPI Number : 1982204152
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFF HENDRICKS PHARMD
Provider Business Mailing Address
First Line : 3813 KINGSWAY DR
Second Line :
City : CROWN POINT
State : IN
Zip : 46307-8982
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5780 FRANKLIN ST
Second Line :
City : MICHIGAN CITY
State : IN
Zip : 46360-7844
Country : US
Telephone Number : 219-872-3309
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2020
Last Update Date : 10/27/2020

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Directions to “ JEFF HENDRICKS PHARMD” Practice Location

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