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General NPI Number Information
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NPI Number | 1033202700
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Entity Type | Organization
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Legal Business Name | HERVEY & BETHARD INC.
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 02/15/2017
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Provider Practice Location Address
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Address Line | 1900 S. HIGH ST.
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City | LONGVIEW
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State | TX
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Zip | 75602
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Country | US
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Telephone | 903-758-8286
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Fax | 903-758-2728
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Provider Business Mailing Address
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Address Line | 1900 S. HIGH ST.
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City | LONGVIEW
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State | TX
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Zip | 75602
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Country | US
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Telephone | 903-758-8286
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Fax | 903-758-2728
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Authorized Official
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Title or Position | PHARMACIST/OWNER
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Name | CHERYL DIANE GILLIAM
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Credential | RPH
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Telephone | 903-758-8286
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 01373
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 01373
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 01373
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 1373
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 1373
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License Number State | TX
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Taxonomy #6
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 1373
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License Number State | TX
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