Provider Demographics
NPI:1497840243
Name:HENDERSON, CHRISTOPHER A (RPH)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:A
Last Name:HENDERSON
Suffix:
Gender:M
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:PO BOX 861
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:VT
Mailing Address - Zip Code:05055-0861
Mailing Address - Country:US
Mailing Address - Phone:802-649-3466
Mailing Address - Fax:
Practice Address - Street 1:5 ROPE FERRY RD
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:NH
Practice Address - Zip Code:03755-1404
Practice Address - Country:US
Practice Address - Phone:603-650-1456
Practice Address - Fax:603-650-6547
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHR1396183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist