Henderson Drug Store,LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PS004501 Issued in MO

Legal business name

HENDERSON DRUG STORE,LLC

Practice address

523 1St St
Glasgow, MO 65254-1005

Phone

(660) 338-2125

Fax

(660) 338-2045

NPI assigned

Oct 3, 2006

Last updated

Feb 16, 2018By 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

David HendersonNPI 1972679868

Title

Owner

Phone

(660) 338-2125

Specialties & licenses 3

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David William Henderson, RPH

  • Pharmacist
  • Glasgow, MO
  • NPI 1972679868
  NPD Authorized official

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518739200000",
    "number": "1912091711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 1ST ST",
            "city": "GLASGOW",
            "state": "MO",
            "postal_code": "652541005",
            "telephone_number": "660-338-2125",
            "fax_number": "660-338-2045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 1ST ST",
            "city": "GLASGOW",
            "state": "MO",
            "postal_code": "652541005",
            "telephone_number": "660-338-2125",
            "fax_number": "660-338-2045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDERSON DRUG STORE,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2018-02-16",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "660-338-2125"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MO",
            "license": "004501",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "PS004501",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "MO",
            "license": "004501",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "600136006",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Leigh Barringhaus, M.S. CCC-SLP
• Chariton Health Systems Inc (Community Medical Equipment)
• Cooper County Memorial Hospital (CCMH Family Health Glasgow)
• Essential Life, LLC
• Melinda Carol Hart, FNP
• David William Henderson, RPH
• Howard County School District R-II
• Teagan Howell
• Steven Michael Jones, DDS
• Jwtdo LLC (Daily Living Home Medical)

• Community/Retail Pharmacy in Glasgow, MO
• Providers in Glasgow, MO by specialty
• Community/Retail Pharmacy in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2018; 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.