NPIMap

Organization Active NPI

Hebron Pharmacy, Inc.

  • Community/Retail Pharmacy
  • Hebron, CT
National Provider Identifier
1265547475
Registry record updated Jul 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PCY.0001062 Issued in CT
Legal business name
HEBRON PHARMACY, INC.
Doing business as
Hebron Pharmacy, Inc.
Practice address
117 Main St
Hebron, CT 06248-1519
Phone
(860) 228-3888
Fax
(860) 228-3391
NPI assigned
Aug 20, 2006
Last updated
Jul 18, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2011

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

Authorized official

Name
Hayden HoustonNPI 1316008808
Title
President
Phone
(860) 228-3888

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PCY.0001062 CT Primary

Addresses

Primary practice location

117 Main St
Hebron, CT 06248-1519

Mailing address

PO Box 155
Hebron, CT 06248-0155

Other identifiers 3

IdentifierTypeStateIssuer
0708137OtherNCPDP PROVIDER IDENTIFICATION NUMBER
004031720MedicaidCT
004063095MedicaidCT

Other names 1

  • HEBRON PHARMACY, INC. Doing business as

National Provider Directory

National Provider Directory

Locations

117 Main St
Hebron, CT 06248
Phone (860) 228-3888

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310947200000",
    "number": "1265547475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 155",
            "city": "HEBRON",
            "state": "CT",
            "postal_code": "062480155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 MAIN ST",
            "city": "HEBRON",
            "state": "CT",
            "postal_code": "062481519",
            "telephone_number": "860-228-3888",
            "fax_number": "860-228-3391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEBRON PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2011-07-18",
        "status": "A",
        "authorized_official_last_name": "HOUSTON",
        "authorized_official_first_name": "HAYDEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "860-228-3888"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CT",
            "license": "PCY.0001062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0708137",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004031720",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004063095",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HEBRON PHARMACY, INC.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hebron, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.