Case Henderson, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

PN06569 Issued in AR

Practice address

111 E Peddicord St
Dermott, AR 71638-2348

Phone

(870) 538-5233

Fax

(870) 538-5717

NPI assigned

Jul 17, 2020

Last updated

Oct 8, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Delta Drug of Dermott, Inc

  dba Delta Drug of Dermott

  • Long Term Care Pharmacy
  • Dermott, AR
  • NPI 1124702592
  NPD
• Delta Drug of Dermott, Inc

  • Community/Retail Pharmacy
  • Dermott, AR
  • NPI 1427191154
  NPD (past)

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

{
    "created_epoch": "1594944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1770191520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 348",
            "city": "DERMOTT",
            "state": "AR",
            "postal_code": "716380348",
            "telephone_number": "870-538-5233",
            "fax_number": "870-538-5717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E PEDDICORD ST",
            "city": "DERMOTT",
            "state": "AR",
            "postal_code": "716382348",
            "telephone_number": "870-538-5233",
            "fax_number": "870-538-5717"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 S 3rd St",
            "address_purpose": "LOCATION",
            "city": "Mc Gehee",
            "state": "AR",
            "postal_code": "716542562",
            "country_code": "US",
            "telephone_number": "870-690-4286",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "CASE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-17",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "PN06569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dermott Day Service Center, Inc. (Morris Booker Early Childhood)
• Dermott Family Practice, Inc.
• Dermott High School (Dermott School District)
• Terri Ann Eubanks, DDS
• Brenda Fowler, ANP
• Shenika Jackson-King, APRN
• Courtney Shay Johnson, CNP
• Elmer Ann Johnson
• Courtney Keller, PHARMD
• Mainline Health Systems Inc (Mainline Dermott Medical Clinic)

• Pharmacist in Dermott, AR
• Providers in Dermott, AR by specialty
• Pharmacist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.