Hereford Pharmacy, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

26063 Issued in TX

Legal business name

HEREFORD PHARMACY, LLC

Doing business as

Hereford Pharmacy

Practice address

809 S 25 Mile Ave
Hereford, TX 79045

Phone

(806) 364-3400

Fax

(806) 364-3405

NPI assigned

Jun 7, 2008

Last updated

May 20, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Christina Marie Moore

Title

Owner

Phone

(806) 995-3551

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Hereford Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in TX3 enrollments

Enrollment records 3

Tax ID family

Hereford Health Mart Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Hereford Pharmacy, LLC

  dba Hereford Health Mart Pharmacy

  • Long Term Care Pharmacy
  • Hereford, TX
  • NPI 1588010037
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1212796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716163200000",
    "number": "1174782825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 S 25 MILE AVE",
            "city": "HEREFORD",
            "state": "TX",
            "postal_code": "790454801",
            "telephone_number": "806-364-3400",
            "fax_number": "806-364-3405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 S 25 MILE AVE",
            "city": "HEREFORD",
            "state": "TX",
            "postal_code": "79045",
            "telephone_number": "806-364-3400",
            "fax_number": "806-364-3405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEREFORD PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-07",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "806-995-3551"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "6298500001",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "26063",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "TX",
            "license": "26063",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "6298500001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "PH0660",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hereford Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hereford Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Louise Heiman, FNP-C
• Hereford Dental PLLC
• Hereford I Enterprises, LLC (Hereford Nursing & Rehabilitation)
• Hereford Investment Group, LLC (Hereford Care Center)
• Hereford Isd
• Hereford Pharmacy, LLC (Hereford Health Mart Pharmacy)
• Levina Christine Herr, FNP
• Sheila Higgins, NP-C
• High Plains Home Medical Equipment, Inc. (High Plains Home Medical)
• Evelyn Veronica Iglesias, FNP-C

• Community/Retail Pharmacy in Hereford, TX
• Providers in Hereford, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.