MEDICARE: LAWRENCE WINSTON HENRY PHARM. D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	20487	NV

General Provider Information

NPI Number	:	1508378571
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAWRENCE WINSTON HENRY PHARM. D

Provider Business Mailing Address
First Line	:	1450 N. MAIN STREET
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89101-4937
Country	:	US
Telephone Number	:	702-307-4635
Fax Number	:	702-307-4631

Provider Business Practice Location Address
First Line	:	1450 N. MAIN STREET
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89101-4937
Country	:	US
Telephone Number	:	702-307-4635
Fax Number	:	702-307-4631

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2017
Last Update Date	:	01/26/2024

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