Hendrix Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP482053 Issued in PA

Legal business name

HENDRIX PHARMACY INC

Doing business as

Hendrix Pharmacy

Practice address

11685 Bustleton Ave
Philadelphia, PA 19116-2542

Phone

(215) 969-3900

Fax

(215) 969-3939

NPI assigned

Apr 26, 2011

Last updated

Nov 29, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gary Kogan, B.S.

Title

Pharmacist

Phone

(215) 969-3900

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Hendrix Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

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

{
    "created_epoch": "1303776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480377600000",
    "number": "1790076610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11685 BUSTLETON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191162542",
            "telephone_number": "215-969-3900",
            "fax_number": "215-969-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11685 BUSTLETON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191162542",
            "telephone_number": "215-969-3900",
            "fax_number": "215-969-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDRIX PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-26",
        "last_updated": "2016-11-29",
        "status": "A",
        "authorized_official_last_name": "KOGAN",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "215-969-3900",
        "authorized_official_credential": "B.S."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP482053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2130086",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hendrix Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shenise Nicole Henderson, LCSW
• Shonquell S Henderson
• Barry Hendler, MD DDS
• Jillian Hendricks, M.A. CCC-SLP
• Summer Hendricks
• Hendrix Vision Center Inc
• Ann Marie Hendrzak, MD
• Liam Heneghan, MD
• Mallorie Heneghan, MD
• Marielle Heneghan, MSW

• Community/Retail Pharmacy in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Community/Retail Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.