Lora Sue Henderson, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

RPH019222 Issued in GA

Practice address

3455 Peachtree Industrial Blvd
Duluth, GA 30096-6501

Phone

(770) 476-7985

Fax

(770) 476-3437

NPI assigned

Oct 21, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1603238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1053910018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 HICKORY KNLS",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300402050",
            "telephone_number": "678-908-5585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3455 PEACHTREE INDUSTRIAL BLVD",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300966501",
            "telephone_number": "770-476-7985",
            "fax_number": "770-476-3437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "LORA",
        "middle_name": "SUE",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-21",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH019222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lora.henderson@stores.kroger.com",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3455 Peachtree Industrial Blvd",
            "city": "Duluth",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300966501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alice R Heimberg-Funk, MD
• Cara Helsel, LCSW
• Maayan Hemphill, RBT
• Virginia N Hemsley, OT
• Lauren Elizabeth Henderson
• Polly A Henderson, MD
• Kathryn Hendley, LMSW
• Carolynn Sue Hendricks, D.C.
• Chasidy Hendricks
• Makaila Hendricks, NP

• Pharmacist in Duluth, GA
• Providers in Duluth, GA by specialty
• Pharmacist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.