Provider Demographics
NPI:1831793082
Name:HENRY, JAMES P (RPH)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:P
Last Name:HENRY
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 1:2000 BLOSSOM RD
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:MA
Mailing Address - Zip Code:02790-1833
Mailing Address - Country:US
Mailing Address - Phone:774-264-0318
Mailing Address - Fax:
Practice Address - Street 1:550 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721-3017
Practice Address - Country:US
Practice Address - Phone:508-678-3945
Practice Address - Fax:508-678-2910
Is Sole Proprietor?:No
Enumeration Date:2020-11-29
Last Update Date:2020-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21295183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist