CARL HENDRICKS (NPI# 1174651442) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174651442 |
| Entity Type | Individual |
| Full Name | CARL HENDRICKS |
| Practice Address |
620 N Pontiac Trl Walled Lake MI 48390-3443 |
| Mailing Address |
753 Gleneagles Highland MI 48357-4778 |
| Practice Telephone | 2486692776 |
| Practice Fax Number | 2486692835 |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 5302026119 | MI | Pharmacy Service Providers |
| Street Address |
620 N PONTIAC TRL |
| City | WALLED LAKE |
| State | MI |
| Zip Code | 48390-3443 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285627802 | Julie Marie Micheli | Physician Assistant | 620 N Pontiac Trl, Walled Lake, MI 48390-3443 | 2005-08-30 |
| 1386195295 | Haley Johnson | Physician Assistant | 620 N Pontiac Trl, Walled Lake, MI 48390-3448 | 2016-10-17 |
| 1013364777 | Kyle Fog | Student in an Organized Health Care Education/Training Program | 620 N Pontiac Trl, Walled Lake, MI 48390-3448 | 2016-05-23 |
| 1760845895 | Madiha Salim | Internal Medicine | 620 N Pontiac Trl, Walled Lake, MI 48390-3448 | 2016-04-05 |
| 1699144584 | Linda Ho | Pharmacy Technician | 620 N Pontiac Trl, Pontiac Trail Pharmacy, Walled Lake, MI 48390-3448 | 2015-09-21 |
| 1063881118 | Kerri Herrin | Pharmacy Technician | 620 N Pontiac Trl, Walled Lake, MI 48390-3448 | 2015-09-18 |
| 1619394004 | Mohammad Saleh | Internal Medicine | 620 N Pontiac Trl, Walled Lake, MI 48390-3448 | 2014-03-24 |
| 1902159437 | Lakes Area Foot and Ankle Care, Pllc | Podiatrist | 620 N Pontiac Trl, Walled Lake, MI 48390-3448 | 2012-10-22 |
| 1104192327 | Beth Maroko | Pharmacist | 620 N Pontiac Trl, Walled Lake, MI 48390-3448 | 2012-04-02 |
| 1467602904 | Michael Anthony Peters | Pharmacist | 620 N Pontiac Trl, Walled Lake, MI 48390-3448 | 2008-09-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043820913 | Elizabeth Ann Manela | Speech-Language Pathologist | 2075 East West Maple Road, Suite B203, Walled Lake, MI 48390 | 2020-08-05 |
| 1205459674 | Allor Outdoor Services LLC | Chore Provider | 3225 E Oakley Park Rd, Commerce Twp, MI 48390 | 2020-05-20 |
| 1467004382 | Convenient Cm PC | Dentist | 2655 Oakley Park Rd, Suite 101, Commerce Twp, MI 48390 | 2019-07-11 |
| 1629535117 | Valerie Baunoch | Nurse Practitioner | 2057 E West Maple Rd, Commerce Twp, MI 48390 | 2019-02-21 |
| 1255858296 | Finn Family Chiropractic Pllc | Chiropractor | 2344 South Commerce Road, Walled Lake, MI 48390 | 2017-08-29 |
| 1588012629 | Shane Macphee | Chiropractor | 2901 Commerce Crossings, Commerce Township, MI 48390 | 2016-05-31 |
| 1245690114 | Lisa Jensen | Nurse Practitioner | 100 West Maple Rd., Walled Lake, MI 48390 | 2016-03-04 |
| 1255725123 | Carissa Karanth | Counselor | 1500 Rustic Lane, Wolverine Lake, MI 48390 | 2015-03-27 |
| 1689095093 | Mabell Omoye Scott | Licensed Vocational Nurse | 724 Owl Court, Wolverine Lake, MI 48390 | 2014-01-02 |
| 1093002230 | Ilze Liene Junkulis-muller | Pharmacist | 495 Haggerty, Traget Pharmacy #0896, Walled Lake, MI 48390 | 2011-07-08 |
| Find all providers in zip 48390 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871962597 | Shawn Marie Wiacek | Pharmacist | 1129 Sigma Rd, Walled Lake, MI 48390-3754 | 2015-09-23 |
| 1093002230 | Ilze Liene Junkulis-muller | Pharmacist | 495 Haggerty, Traget Pharmacy #0896, Walled Lake, MI 48390 | 2011-07-08 |
| 1477161933 | Justin John Kajy | Pharmacist | 100 W West Maple Rd, Walled Lake, MI 48390-3402 | 2020-07-20 |
| 1689205429 | May S Kasgorgis | Pharmacist | 100 W West Maple Rd, Walled Lake, MI 48390-3402 | 2020-01-30 |
| 1629609565 | Reema Hakim | Pharmacist | 100 W West Maple Rd, Walled Lake, MI 48390-3402 | 2020-01-29 |
| 1922586148 | Evano Kashat | Pharmacist | 100 W West Maple Rd, Walled Lake, MI 48390-3402 | 2018-07-31 |
| 1104192327 | Beth Maroko | Pharmacist | 620 N Pontiac Trl, Walled Lake, MI 48390-3448 | 2012-04-02 |
| 1467602904 | Michael Anthony Peters | Pharmacist | 620 N Pontiac Trl, Walled Lake, MI 48390-3448 | 2008-09-21 |
| 1386772648 | Karen Hendricks | Pharmacist | 620 N Pontiac Trl, Walled Lake, MI 48390-3443 | 2007-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609477710 | Alix Sabbagh | Pharmacist | 154 River Ln, Dearborn, MI 48124-1047 | 2020-11-04 |
| 1659972867 | Bruce Alan Gilmore | Pharmacist | 5940 Augusta Ln, Grand Blanc, MI 48439-9473 | 2020-11-04 |
| 1437750551 | Anamiben R Patel | Pharmacist | 45555 Michigan Ave, Canton, MI 48188-2388 | 2020-11-04 |
| 1871194217 | Rajesh Koduru | Pharmacist | 27496 Pamplona Ln, Novi, MI 48374-4208 | 2020-11-03 |
| 1346841962 | Joy Emery | Pharmacist | 1770 N Alger Road, Alma, MI 48001 | 2020-11-02 |
| 1659972107 | Jane Gruenke | Pharmacist | N10305 Country Club Rd, Ironwood, MI 49938-9627 | 2020-11-02 |
| 1407456254 | Bradley Dwane Murphy | Pharmacist | 6170 S Saginaw, Grand Blanc, MI 48439 | 2020-10-30 |
| 1811597602 | Rachel L Martin | Pharmacist | 600 N Center Ave, Gaylord, MI 49735-1506 | 2020-10-29 |
| 1760081467 | Sam Nasser | Pharmacist | 6610 Reuter St, Dearborn, MI 48126-1898 | 2020-10-22 |
| 1427656990 | Tejal Shah | Pharmacist | 1153 Pembroke Dr, Rochester Hills, MI 48307-5756 | 2020-10-15 |
| Find all providers with the same taxonomy | ||||
| City | WALLED LAKE |
| Zip Code | 48390 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.