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MR. EARL R.. HENDERSON RPH.
>> Pharmacist >> Pharmacy Service ProvidersRegistrant NPI Number: 1851359061
Individual Registrant:MR. EARL R.. HENDERSON RPH.
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
220 W CENTRAL AVE FITZGERALD, GA 31750-2438 US
Tel: 229-423-0521 Fax: --
Tel: 229-423-0521 Fax: --
Contact information for business:
PO BOX 144 CHULA, GA 31733-0144 US
Tel: 229-382-2779 Fax: --
Tel: 229-382-2779 Fax: --
Registration Information:
NPI: 1851359061
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 183500000X | Pharmacy Service Providers Pharmacist | GA | 009881 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
