Organization
HENDERSON'S DRUG STORE, INC.
Active
Other names
Fall Street Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE A JEPSEN (PRESIDENT)
(607) 535-4999
Entity
Organization
Contact information
Practice address
95 FALL ST, SENECA FALLS, NY 13148-1408
(315) 568-1700
(315) 568-1300
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
026462
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02522672
—
NY
Enumeration date
04/25/2006
Last updated
03/04/2010
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