Henderson's Drug Store, Inc.

Primary specialty

PharmacyTaxonomy code 333600000X

License

024380 Issued in NY

Legal business name

HENDERSON'S DRUG STORE, INC.

Practice address

200 North St
Suite 103
Geneva, NY 14456-1561

Phone

(315) 787-5388

Fax

(315) 781-3295

NPI assigned

Apr 25, 2006

Last updated

Mar 4, 2010By 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

Lawrence A Jepsen

Title

President

Phone

(607) 535-4999

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Geneva Other name

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Naples Pharmacy, Inc.

  • Pharmacy
  • Naples, NY
  • NPI 1811953201

  Member Of

  NPD member

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267660800000",
    "number": "1639135809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 696",
            "city": "WATKINS GLEN",
            "state": "NY",
            "postal_code": "148910696",
            "telephone_number": "607-535-4999",
            "fax_number": "607-535-4320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NORTH ST",
            "address_2": "SUITE 103",
            "city": "GENEVA",
            "state": "NY",
            "postal_code": "144561561",
            "telephone_number": "315-787-5388",
            "fax_number": "315-781-3295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDERSON'S DRUG STORE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-25",
        "last_updated": "2010-03-04",
        "status": "A",
        "authorized_official_last_name": "JEPSEN",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "607-535-4999"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NY",
            "license": "024380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01981828",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Geneva",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Heidi Anne Haus, CCC-SLP
• Mark R Hedgepeth, LCSW R
• Tracy Heffron, PA
• Sierralynn Marie Helming, PA-C
• Daniela Henderson
• Christopher Lee Henthorne, D.C.
• David Andrew Herd, D.C.
• Frances B Herd, PNP
• James Hight, MD
• Pamela F. Hobart, NP

• Pharmacy in Geneva, NY
• Providers in Geneva, NY by specialty
• Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2010; 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.