Individual ProviderDesmond HendersonRegistered NurseNursing Service ProvidersPractice Address119 W Main St, Middletown, NY 10940-4935(845) 381-3818PECOS EnrollmentBased on the most recent information from CMS, provider Desmond Henderson does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1497512701Provider TypeIndividualFull NameHenderson, DesmondGenderMaleSole ProprietorNoEnumeration Date3/4/2024Last Updated3/4/2024Contact InformationPractice LocationPractice Address119 W Main St, Middletown, NY 10940-4935Phone(845) 381-3818FaxUnlisted FaxMailing LocationMailing Address119 W Main St, Middletown, NY 10940-4935Phone(845) 381-3818FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode163W00000XPrimaryDescriptionRegistered NurseNursing Service ProvidersLicense735531New York