LORA SUE HENDERSON (NPI# 1053910018) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053910018 |
| Entity Type | Individual |
| Full Name | LORA SUE HENDERSON |
| Credential | PHARMD |
| Practice Address |
3455 Peachtree Industrial Blvd Duluth GA 30096-6501 |
| Mailing Address |
109 Hickory Knls Cumming GA 30040-2050 |
| Practice Telephone | 7704767985 |
| Practice Fax Number | 7704763437 |
| Mailing Telephone | 6789085585 |
| Enumeration Date | 2020-10-21 |
| Last Update Date | 2020-10-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | RPH019222 | GA | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720571441 | Lora Jelise Henderson | Student in an Organized Health Care Education/Training Program | 801 N Broadway, Baltimore, MD 21205-1424 | 2018-06-07 |
| 1326478538 | Lora Henderson | Case Manager/Care Coordinator | 758 S 1st St, Center One, Louisville, KY 40202-2023 | 2013-11-25 |
| 1245572114 | Lora Carol Henderson | Registered Nurse | 100 Blassingame Rd, Greenville, SC 29605-3304 | 2013-03-19 |
| Street Address |
3455 PEACHTREE INDUSTRIAL BLVD |
| City | DULUTH |
| State | GA |
| Zip Code | 30096-6501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982607222 | Medical Aid Supply House Inc | Prosthetic/Orthotic Supplier | 3455 Peachtree Industrial Blvd, Ste 980, Duluth, GA 30096-6506 | 2005-05-31 |
| 1639778459 | Calvin So | Pharmacist | 3455 Peachtree Industrial Blvd, Duluth, GA 30096-6501 | 2020-10-22 |
| 1447858931 | Jimin Sun | Pharmacist | 3455 Peachtree Industrial Blvd, Duluth, GA 30096-6501 | 2020-10-15 |
| 1851921092 | Laurel Ip | Pharmacist | 3455 Peachtree Industrial Blvd, Duluth, GA 30096-6501 | 2020-01-15 |
| 1922476308 | Pt Solutions of Acworth, LLC | Physical Therapist | 3455 Peachtree Industrial Blvd, Suite 825, Duluth, GA 30096-6501 | 2015-09-02 |
| 1790152858 | Fabius Clements Iv | Optometrist | 3455 Peachtree Industrial Blvd, Suite 845, Duluth, GA 30096-6501 | 2015-08-25 |
| 1730304858 | Lisa Mary Brodsky | Dentist | 3455 Peachtree Industrial Blvd, Ste. 805, Duluth, GA 30096-6501 | 2007-04-16 |
| 1619093531 | Gwinnett Eye Clinic | Optometrist | 3455 Peachtree Industrial Blvd, Suite 845, Duluth, GA 30096-6501 | 2007-03-22 |
| 1184703464 | Phillip E Johnson | Optometrist | 3455 Peachtree Industrial Blvd, Suite 845, Duluth, GA 30096-6501 | 2006-11-06 |
| 1548285224 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 3455 Peachtree Industrial Blvd, Duluth, GA 30096-6501 | 2006-07-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922615897 | Georgia Eye Optical, LLC | Ophthalmology | 3800 Pleasant Hill Rd Ste 3, Duluth, GA 30096 | 2020-09-25 |
| 1568090868 | Positive Behavior Services, Inc | Behavior Technician | 3765 Crestwood Pkwy Nw, Duluth, GA 30096 | 2020-03-31 |
| 1861031940 | Elizabeth Ashley Edouard | Counselor | 3464 Duluth Hwy 120, Duluth, GA 30096 | 2020-01-06 |
| 1245701044 | Kathryn Irene Vaughn | Social Worker | 3968 Mainsail Court, Duluth, GA 30096 | 2018-12-06 |
| 1083184626 | Aica Orthopedics, P.C. | Orthopaedic Surgery | 3775 Venture Drive Bldg F, Duluth, GA 30096 | 2018-11-27 |
| 1245709799 | Positive Impact Health Centers, Inc. | Pharmacy | 3350 Breckinridge Blvd, Suite 200a, Duluth, GA 30096 | 2018-11-14 |
| 1235611724 | Katherine Winstead Knott | Counselor | 3460 Summit Ridge Parkway, Suite 503, Duluth, GA 30096 | 2018-08-31 |
| 1710467857 | Envision Optics LLC | Optometrist | 1943 Pleasant Hill Rd, Duluth, GA 30096 | 2018-08-17 |
| 1104314202 | Erin Mckernan Scupham | Chiropractor | 3820 Pleasant Hill Rd. Ne, Suite 4, Duluth, GA 30096 | 2018-04-25 |
| 1053839456 | Rogers Bridge Pediatric Therapy, LLC | Clinic/Center | 2845 Summercrest Ln, Duluth, GA 30096 | 2017-09-06 |
| Find all providers in zip 30096 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801364062 | Dongwoo Shin | Pharmacist | 3607 Gainesway Ct, Duluth, GA 30096-1738 | 2018-11-06 |
| 1174091359 | Naeunnansae Lim | Pharmacist | 2370 Main St Nw Apt 5301, Duluth, GA 30097-2876 | 2018-11-06 |
| 1851818579 | Ji A Kim | Pharmacist | 2550 Pleasant Hill Road, Suite 120, Duluth, GA 30096 | 2017-08-23 |
| 1821442153 | Lyhka5 LLC | Pharmacist | 4470 Satellite Blvd Ste 108, Duluth, GA 30096-8852 | 2016-04-22 |
| 1932517257 | Ja Young Kongkim | Pharmacist | 4195 Pleasant Hill Rd, Suite D, Duluth, GA 30096-6343 | 2014-07-30 |
| 1316362213 | Darshini Jani | Pharmacist | 3463 Palisade Park Ct, Duluth, GA 30096-6698 | 2014-02-28 |
| 1104266345 | Rebecca Wright | Pharmacist | 202 N Central Ave, Duluth, MN 55807-2463 | 2013-07-02 |
| 1538419767 | Kyle Robert Rizzi | Pharmacist | 231 E 14th St, Duluth, MN 55811-3767 | 2012-09-14 |
| 1366701930 | Laura Jean Gauger | Pharmacist | 1321 E 1st St, # 201, Duluth, MN 55805-2453 | 2012-05-16 |
| 1497023410 | Jean Barrie Mcbride | Pharmacist | 1131 East Superior Street, Duluth, MN 55802 | 2011-12-05 |
| Find all providers in DULUTH | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.