Organization
HENDERSON'S DRUG STORE, INC.
Active
Other names
Montour Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE A JEPSEN (PRESIDENT)
(607) 535-4999
Entity
Organization
Contact information
Practice address
320 W MAIN STREET, MONTOUR FALLS, NY 14865
(607) 535-7272
(607) 535-4079
Mailing address
PO BOX 696, WATKINS GLEN, NY 14891-0696
(607) 535-4999
(607) 535-4320
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
025563
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02363844
—
NY
Enumeration date
04/27/2006
Last updated
03/04/2010
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