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General NPI Number Information
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NPI Number | 1487379970
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Entity Type | Individual
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Provider Name | SIDNEY WINTERS HENDRY
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Gender | Female
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Dates
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Enumeration Date | 10/06/2022
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Last Update Date | 10/06/2022
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Provider Practice Location Address
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Address Line | 130 DESIARD ST STE 300
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City | MONROE
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State | LA
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Zip | 71201-7363
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Country | US
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Telephone | 318-998-3907
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Fax | 318-812-6020
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Provider Business Mailing Address
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Address Line | 307 SUSAN DR
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City | WEST MONROE
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State | LA
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Zip | 71291-1219
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Country | US
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Telephone | 318-557-0126
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 024586
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License Number State | LA
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