Karen Hendricks

Primary specialty

PharmacistTaxonomy code 183500000X

License

5302025889 Issued in MI

Practice address

620 N Pontiac TRL
Walled Lake, MI 48390-3443

Phone

(248) 669-2776

Fax

(248) 669-2835

NPI assigned

Mar 1, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Pontiac Trail Pharmacy Inc

  dba Pontiac Trail Medical Pharmacy

  • Community/Retail Pharmacy
  • Walled Lake, MI
  • NPI 1902914377
  NPD

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386772648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "753 GLENEAGLES",
            "city": "HIGHLAND",
            "state": "MI",
            "postal_code": "483574778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 N PONTIAC TRL",
            "city": "WALLED LAKE",
            "state": "MI",
            "postal_code": "483903443",
            "telephone_number": "248-669-2776",
            "fax_number": "248-669-2835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKS",
        "first_name": "KAREN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302025889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Salvatore Halmaghi, DDS
• Jacklyn Joan-Marie Hansen
• Emma Mary Harris
• Steven Hechtman, D.D.S.
• Carl Hendricks
• Henry Ford Health System (Henry Ford Health Products)
• Henry Ford West Bloomfield Physicians
• Kerri Herrin
• Ariel Hill
• Linda Ho, CPHT

• Pharmacist in Walled Lake, MI
• Providers in Walled Lake, MI by specialty
• Pharmacist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.