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General NPI Number Information
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NPI Number | 1174782825
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Entity Type | Organization
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Legal Business Name | HEREFORD PHARMACY, LLC
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Dates
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Enumeration Date | 06/07/2008
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Last Update Date | 05/20/2024
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Provider Practice Location Address
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Address Line | 809 S 25 MILE AVE
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City | HEREFORD
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State | TX
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Zip | 79045
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Country | US
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Telephone | 806-364-3400
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Fax | 806-364-3405
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Provider Business Mailing Address
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Address Line | 809 S 25 MILE AVE
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City | HEREFORD
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State | TX
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Zip | 79045-4801
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Country | US
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Telephone | 806-364-3400
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Fax | 806-364-3405
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTINA MARIE MOORE
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Credential |
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Telephone | 806-995-3551
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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 | 6298500001
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 26063
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 26063
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License Number State | TX
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