Provider Demographics
NPI:1336702745
Name:HENRY, DOLORES ANN (RPH)
Entity Type:Individual
Prefix:
First Name:DOLORES
Middle Name:ANN
Last Name:HENRY
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 1:201 E CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2781
Mailing Address - Country:US
Mailing Address - Phone:717-393-3814
Mailing Address - Fax:717-393-7537
Practice Address - Street 1:201 E CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2705
Practice Address - Country:US
Practice Address - Phone:717-393-3814
Practice Address - Fax:717-393-7537
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-22
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP034144L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist