Organization
HENDERSON PHARMACY LLC
Active
Other names
Henderson Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY GLEN BALDWIN PHARMD (PIC)
(402) 723-4475
Entity
Organization
Contact information
Practice address
1060 N MAIN ST, HENDERSON, NE 68371-9798
(402) 723-4475
(402) 723-4476
Mailing address
PO BOX 711, HENDERSON, NE 68371-0711
(402) 723-4475
(402) 723-4476
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10026916700
—
NE
Enumeration date
01/06/2022
Last updated
10/24/2024
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