Individual
CASE HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
111 E PEDDICORD ST, DERMOTT, AR 71638-2348
(870) 538-5233
(870) 538-5717
Mailing address
PO BOX 348, DERMOTT, AR 71638-0348
(870) 538-5233
(870) 538-5717
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PN06569
AR
Other
Enumeration date
07/17/2020
Last updated
10/08/2020
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