Marty Lee Hendrick, PHARM D

Primary specialty

PharmacistTaxonomy code 183500000X

License

26880 Issued in NC

Practice address

4961 Long Beach Rd SE
Southport, NC 28461-8152

Phone

(910) 457-9566

Fax

(910) 457-9566

NPI assigned

Sep 24, 2011

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Tulsa, OK
  • NPI 1982619961
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1316822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1013290105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4961 LONG BEACH RD SE",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284618152",
            "telephone_number": "910-457-9566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4961 LONG BEACH RD SE",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284618152",
            "telephone_number": "910-457-9566",
            "fax_number": "910-457-9566"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5104 S Lewis Ave",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741056542",
            "country_code": "US",
            "telephone_number": "918-747-8841",
            "fax_number": "918-747-6639",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDRICK",
        "first_name": "MARTY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "PHARM D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-24",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "26880",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OK",
            "license": "13854",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Pace Harrington, MPT
• Ziaollah Hashemi, M.D.
• Joseph P Hatem, MD
• Denise Beth Hayes, RPH, MS, CCP
• Rebecca Jane Hedgecock, MA, NCC, LPC
• Anne Marie Henschel
• Rick J Hernandez, M.D.
• Mark Herzog, PTA
• Kaylee Heschke
• Carol H Hester, MA

• Pharmacist in Southport, NC
• Providers in Southport, NC by specialty
• Pharmacist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.