Lauren Henrichs
Individual provider Active NPI Pharmacist · Aviston, IL
NPI 1245623933 · NPPES record last updated Mar 5, 2015
Key facts
- NPI
- 1245623933
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 051.296126 (IL)
- Practice address
- 820 W 2ND St
Aviston, IL 62216-3464 - Phone
- (618) 604-4849
- NPI assigned
- Mar 5, 2015
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051.296126 | IL | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051.296126 | IL | Yes |
Addresses
Primary practice location
820 W 2ND St
Aviston, IL 62216-3464
Mailing address
820 W 2ND St
Aviston, IL 62216-3464
Other providers in Aviston, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 5, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.