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NPI Code Detail

MEDICARE: JULIE HENDERSON

MEDICARE: JULIE HENDERSON
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
1183500000XPharmacist03230368-2OH

General Provider Information

NPI Number : 1649705039
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIE HENDERSON
Provider Business Mailing Address
First Line : 4656 CEMETERY RD
Second Line :
City : HILLIARD
State : OH
Zip : 43026-1298
Country : US
Telephone Number : 614-876-1248
Fax Number :
Provider Business Practice Location Address
First Line : 4656 CEMETERY RD
Second Line :
City : HILLIARD
State : OH
Zip : 43026-1298
Country : US
Telephone Number : 614-876-1248
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2017
Last Update Date : 04/24/2017

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