Provider Demographics
NPI:1912089053
Name:HENCH ENTERPRISES INC
Entity type:Organization
Organization Name:HENCH ENTERPRISES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CORPORATE SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:STAFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-782-0950
Mailing Address - Street 1:1340 W HIGH ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:DEFIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:43512-5302
Mailing Address - Country:US
Mailing Address - Phone:419-782-0950
Mailing Address - Fax:419-782-6047
Practice Address - Street 1:2100 HARDING HWY
Practice Address - Street 2:STE 12
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804-3443
Practice Address - Country:US
Practice Address - Phone:419-222-9355
Practice Address - Fax:419-224-5013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
OH0216130003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2698942Medicaid
3675103OtherNCPDP PROVIDER IDENTIFICATION NUMBER
3990720002Medicare NSC