Provider Demographics
NPI:1083300776
Name:MCHENRY, SUE A (RPH)
Entity Type:Individual
Prefix:
First Name:SUE
Middle Name:A
Last Name:MCHENRY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 FEDERAL STREET
Mailing Address - Street 2:JHC PHARMACY
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24504
Mailing Address - Country:US
Mailing Address - Phone:434-455-3265
Mailing Address - Fax:
Practice Address - Street 1:320 FEDERAL STREET
Practice Address - Street 2:JOHNSON HEALTH CENTER PHARMACY
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24504
Practice Address - Country:US
Practice Address - Phone:434-455-3265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-14
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202005507183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist