Provider Demographics
NPI:1336737808
Name:HENDERSON, WILLIAM LAWRENCE (PHARMD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:LAWRENCE
Last Name:HENDERSON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1911 BEL AIR RD
Mailing Address - Street 2:
Mailing Address - City:FALLSTON
Mailing Address - State:MD
Mailing Address - Zip Code:21047-2723
Mailing Address - Country:US
Mailing Address - Phone:410-877-0611
Mailing Address - Fax:410-877-0611
Practice Address - Street 1:1911 BEL AIR RD
Practice Address - Street 2:
Practice Address - City:FALLSTON
Practice Address - State:MD
Practice Address - Zip Code:21047-2723
Practice Address - Country:US
Practice Address - Phone:410-877-0611
Practice Address - Fax:410-877-0611
Is Sole Proprietor?:No
Enumeration Date:2021-01-09
Last Update Date:2021-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26026790A183500000X
MD24298183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist