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Organization

HENDERSON'S DRUG STORE, INC.

Active
Other names
Penn Yan
Organization subpart
No

Provider details

NPI number
Authorized official
LAWRENCE A JEPSEN (PRESIDENT)
(607) 535-4999
Entity
Organization

Contact information

Practice address
126 MAIN ST, PENN YAN, NY 14527-1219
(315) 536-4448
(315) 536-5043
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
006743
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01632140
NY
Enumeration date
04/24/2006
Last updated
03/04/2010
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