Organization Active NPI

H-E-B LP

  • Community/Retail Pharmacy
  • Mansfield, TX
National Provider Identifier
1205697455
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
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

Updated by the provider on Nov 6, 2024

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)CodeLicenseStatePrimary
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 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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 NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2306152Heb Pharmacy #7501670 East Broad Street, Mansfield, TX 76063Certificate of waiverJun 11, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Heb Pharmacy #7501670 E Broad St, Mansfield, TX 76063-1862(817) 900-8386 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order) Accepts assignmentParticipating since Dec 21, 2011

National Provider Directory

National Provider Directory
Tax ID family
Heb Pharmacy 0017352 organizations share this tax ID, including this one

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.

View all 24

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.

Verify at the official NPI Registry.