Healthcare Provider Details

I. General information

NPI: 1821637802
Provider Name (Legal Business Name): AIMEE HENDERSON PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/23/2019
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 NW 9TH ST STE 205
OKLAHOMA CITY OK
73102-1077
US

IV. Provider business mailing address

535 NW 9TH ST STE 205
OKLAHOMA CITY OK
73102-1077
US

V. Phone/Fax

Practice location:
  • Phone: 405-772-4338
  • Fax: 405-772-4099
Mailing address:
  • Phone: 405-772-4338
  • Fax: 405-772-4099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number13005
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: