Larry Anthony Henken, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

051038689 Issued in IL

Practice address

1520 Mascoutah Ave
Belleville, IL 62220-3631

Phone

(618) 235-2204

Fax

(314) 921-1036

NPI assigned

Dec 4, 2020

Last updated

Dec 4, 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1607040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607040000000",
    "number": "1831794999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 RUTH DR",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622692444",
            "telephone_number": "618-444-9377",
            "fax_number": "314-921-1036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 MASCOUTAH AVE",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622203631",
            "telephone_number": "618-235-2204",
            "fax_number": "314-921-1036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENKEN",
        "first_name": "LARRY",
        "middle_name": "ANTHONY",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-04",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2016003862",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051038689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Belleville, IL
• Providers in Belleville, IL by specialty
• Pharmacist in Illinois

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