Active NPI
H-E-B LP
- Community/Retail Pharmacy
- Mansfield, TX
National Provider Identifier
1205697455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- H-E-B LP
- Practice address
- 1670 E Broad St
Mansfield, TX 76063-1862 - Phone
- (817) 900-8386
- NPI assigned
- Jan 16, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jay Bueche
- Title
- Managing Director of Pharmacy
- Phone
- (210) 938-3182
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Military Clinical Medical Laboratory | 291900000X | |||
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
1670 E Broad St
Mansfield, TX 76063-1862
Mailing address
646 S Flores St
San Antonio, TX 78204-1219
Other names 1
- HEB Pharmacy #750
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 2
| 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 |
| O20241004002518 | TX | DME Supplier - Pharmacy | 8224190871 | Practice locations: Mansfield, TX |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D2306152 | Heb Pharmacy #750 | Certificate of waiver | Jun 11, 2028 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Heb Pharmacy #750 | Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order) | Accepts assignment |
National Provider Directory
National Provider Directory- Tax ID family
- Heb Pharmacy 00173
Organizations with this tax ID in the same state 24
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
- Pharmacy
- Austin, TX
- NPI 1457083248
-
- Eyewear Supplier
- San Antonio, TX
- NPI 1053842286
-
- Community/Retail Pharmacy
- Humble, TX
- NPI 1063287571
-
- Community/Retail Pharmacy
- Katy, TX
- NPI 1073318903
-
- Community/Retail Pharmacy
- Katy, TX
- NPI 1083486807
-
- Health Service Clinic/Center
- San Antonio, TX
- NPI 1093170383
-
- Community/Retail Pharmacy
- Murphy, TX
- NPI 1093667719
-
- Community/Retail Pharmacy
- Euless, TX
- NPI 1093685596
-
- Community/Retail Pharmacy
- Irving, TX
- NPI 1104778265
-
- Eyewear Supplier
- San Antonio, TX
- NPI 1114458361
-
- Community/Retail Pharmacy
- Manor, TX
- NPI 1134018583
-
- Community/Retail Pharmacy
- San Antonio, TX
- NPI 1164044392
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1705363200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1730851200000",
"number": "1205697455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "646 S FLORES ST",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782041219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1670 E BROAD ST",
"city": "MANSFIELD",
"state": "TX",
"postal_code": "760631862",
"telephone_number": "817-900-8386"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "H-E-B LP",
"organizational_subpart": "NO",
"enumeration_date": "2024-01-16",
"last_updated": "2024-11-06",
"certification_date": "2024-11-06",
"status": "A",
"authorized_official_last_name": "BUECHE",
"authorized_official_first_name": "JAY",
"authorized_official_title_or_position": "MANAGING DIRECTOR OF PHARMACY",
"authorized_official_telephone_number": "210-938-3182"
},
"taxonomies": [
{
"code": "291900000X",
"taxonomy_group": "",
"desc": "Military Clinical Medical Laboratory",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "HEB Pharmacy #750",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "HEB Pharmacy #750",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Mansfield, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.