Provider Demographics
NPI:1124304118
Name:HENDRIX, TAMMY (RPH)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:HENDRIX
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 CHAPIN RD
Mailing Address - Street 2:
Mailing Address - City:CHAPIN
Mailing Address - State:SC
Mailing Address - Zip Code:29036-8874
Mailing Address - Country:US
Mailing Address - Phone:803-345-0759
Mailing Address - Fax:
Practice Address - Street 1:1401 CHAPIN RD
Practice Address - Street 2:
Practice Address - City:CHAPIN
Practice Address - State:SC
Practice Address - Zip Code:29036-8874
Practice Address - Country:US
Practice Address - Phone:803-345-0759
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-23
Last Update Date:2011-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7859183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist