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General NPI Number Information
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NPI Number | 1508175100
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Entity Type | Organization
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Legal Business Name | HENDERSON FIRST AID INC
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Dates
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Enumeration Date | 09/29/2010
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Last Update Date | 09/29/2010
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Provider Practice Location Address
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Address Line | 110 3RD ST
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City | HENDERSON
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State | KY
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Zip | 42420-2993
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Country | US
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Telephone | 270-454-4177
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Fax |
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Provider Business Mailing Address
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Address Line | 2202 HIGHWAY 41 N E-129
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City | HENDERSON
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State | KY
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Zip | 42420-2399
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Country | US
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Telephone | 270-454-4177
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. SAMUEL C DUNLANY
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Credential | M.D.
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Telephone | 270-454-4177
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 17464
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License Number State | KY
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