Henderson, Jere David
Henderson, Jere David is an sole proprietor health care provider with primary practice located at 1381 Nw Garden Valley Blvd , Roseburg OR 97471-1790. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Henderson, Jere David can be contacted via phone (541) 672-5738.Contact Information
Primary practice address
1381 Nw Garden Valley Blvd
Roseburg OR 97471-1790
Phone: (541) 672-5738
Fax: (541) 672-8520
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Pharmacy Service Providers / Pharmacist | 183500000X | 6429 | Oregon |
Profile Details
| NPI number | 1629341318 |
|---|---|
| LBN Legal business name | Henderson, Jere David |
| Credentials | R.PH. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 11th, 2012 |
| Last updated | Feb 11th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629341318 | NPPES |
| Oregon | Other | 6429 | STATE PHARMACIST LICENSE |
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