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General NPI Number Information
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NPI Number | 1750373064
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Entity Type | Organization
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Legal Business Name | HERBST APOTHECARY INC
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Dates
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Enumeration Date | 08/22/2005
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Last Update Date | 03/09/2024
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Provider Practice Location Address
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Address Line | 201 N DIXON RD
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City | KOKOMO
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State | IN
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Zip | 46901-4131
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Country | US
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Telephone | 765-457-1191
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Fax | 765-868-3184
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Provider Business Mailing Address
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Address Line | 201 N DIXON RD
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City | KOKOMO
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State | IN
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Zip | 46901-4131
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Country | US
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Telephone | 765-457-1191
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Fax | 765-868-3184
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Authorized Official
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Title or Position | PRESIDENT
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Name | HEIDI TANNER
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Credential | RPH
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Telephone | 765-457-1191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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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 | 60002425A
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License Number State | IN
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