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Organization
HENDERSON PHARMACY
Active
Organization
HENDERSON PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EARL D HENDERSON RPH (OWNER/PHARMACIST)
(318) 645-6116
Entity
Organization
Contact information
Practice address
1169 N MAIN ST, ZWOLLE, LA 71486-3501
(318) 645-6116
(318) 645-2209
Mailing address
PO BOX 608, ZWOLLE, LA 71486-0608
(318) 645-6116
(318) 645-2209
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY.000449-IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1904728
—
LA
Enumeration date
06/13/2017
Last updated
06/13/2017
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