Provider Demographics
NPI:1508175100
Name:HENDERSON FIRST AID INC
Entity Type:Organization
Organization Name:HENDERSON FIRST AID INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:DUNLANY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:270-454-4177
Mailing Address - Street 1:2202 HIGHWAY 41 N
Mailing Address - Street 2:E-129
Mailing Address - City:HENDERSON
Mailing Address - State:KY
Mailing Address - Zip Code:42420-2399
Mailing Address - Country:US
Mailing Address - Phone:270-454-4177
Mailing Address - Fax:
Practice Address - Street 1:110 3RD ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:KY
Practice Address - Zip Code:42420-2993
Practice Address - Country:US
Practice Address - Phone:270-454-4177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-29
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY17464207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty