H-E-B, LP
Organization Active NPI Community/Retail Pharmacy · Bay City, TX
NPI 1104935543 · NPPES record last updated Sep 23, 2020
Key facts
- NPI
- 1104935543
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 21128 (TX)
- Legal business name
- H-E-B, LP
- Practice address
- 2700 7TH St
Bay City, TX 77414 - Phone
- (979) 245-1881
- Fax
- (979) 244-1945
- NPI assigned
- Aug 30, 2006
- Organization subpart
- No
Authorized official
- Name
- David Liendo
- Title
- Government Programs Manager
- Phone
- (210) 938-3182
Practitioners 11
-
Dena Shea Daniell, RPH
-
The Nguyen, PHARMD
-
Kandace Ann O'Mallan, PHARM.D.
-
Tiffany Sieben, PHARM.D.
-
Truman Warrem, PHARMD
-
Mary Elizabeth Young, REGISTERED PHARMACIS
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D1071546 | Heb Pharmacy #292 LP | Certificate of waiver | Jul 26, 2027 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Heb Pharmacy #292 |
Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order) | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20081216000621 | TX | Part B Supplier - Mass Immunization (Roster Biller Only) | 8224190871 | This NPI is an additional NPI on the enrollment |
| O20100930060227 | TX | DME Supplier - Pharmacy | 8224190871 | Practice locations: Bay City, TX |
National Provider Directory
Locations
2700 7th St
Bay City, TX 77414
Phone (979) 245-1881
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 21128 | TX | Yes |
Addresses
Primary practice location
2700 7TH St
Bay City, TX 77414
Mailing address
646 South Flores
San Antonio, TX 78204
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4580379 | Other | NCPDP PROVIDER IDENTIFICATION NUMBER | |
| 469197 | Medicaid | TX |
Other names
- HEB Pharmacy #292
Other providers in Bay City, TX
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- George P Hanna
- Harmony Health and Wellness LLC
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All providers in Bay City, TX · Community/Retail Pharmacy in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 23, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.