Provider Demographics
NPI:1508378571
Name:HENRY, LAWRENCE WINSTON (PHARM D)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:WINSTON
Last Name:HENRY
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 N. MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89101-4937
Mailing Address - Country:US
Mailing Address - Phone:702-307-4635
Mailing Address - Fax:702-307-4631
Practice Address - Street 1:1450 N. MAIN STREET
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-4937
Practice Address - Country:US
Practice Address - Phone:702-307-4635
Practice Address - Fax:702-307-4631
Is Sole Proprietor?:No
Enumeration Date:2017-10-31
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV20487183500000X
CA767681835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
Yes183500000XPharmacy Service ProvidersPharmacist