Henneberry Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP410745L Issued in PA

Legal business name

HENNEBERRY PHARMACY

Practice address

838 N 24TH St
Philadelphia, PA 19130-1914

Phone

(215) 765-1033

NPI assigned

Aug 29, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Charles Henneberry

Title

Owner

Phone

(215) 765-1033

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1568571370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "838 N 24TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191301914",
            "telephone_number": "215-765-1033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "838 N 24TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191301914",
            "telephone_number": "215-765-1033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENNEBERRY PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HENNEBERRY",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-765-1033",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP410745L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005770300001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristin Henkel, M.S., CCC-SLP
• Emily Jane Henkelman, M.D.
• Lynette Henley
• Randa P Hennawy, M.D.
• Terrence E. Henne, M.D.
• Marie Oliva Hennelly, M.D.
• Michael M. Hennelly, D.O.
• Anne Kathryn Henner, MSN, AGPCNP-BC
• Ashley Hennessey, PSYD
• Daniel Hennessey, DPM

• Community/Retail Pharmacy in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Community/Retail Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.