NPIMap

Organization Active NPI

Herbst Apothecary Inc

Doing business as Herbst Pharmacy

  • Community/Retail Pharmacy
  • Kokomo, IN
National Provider Identifier
1295727501
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
60004199A Issued in IN
Legal business name
HERBST APOTHECARY INC
Doing business as
Herbst Pharmacy
Practice address
300 E Southway Blvd Ste E
Kokomo, IN 46902-3678
Phone
(765) 455-5418
Fax
(765) 455-5724
NPI assigned
Aug 22, 2005
Last updated
Feb 28, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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

Authorized official

Name
Heidi Tanner, RPHNPI 1437231016
Title
President
Phone
(765) 457-1191

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 60004199A IN Primary

Addresses

Primary practice location

300 E Southway Blvd Ste E
Kokomo, IN 46902-3678

Mailing address

300 E Southway Blvd Ste E
Kokomo, IN 46902-3678
Phone (765) 455-5418

Other identifiers 2

IdentifierTypeStateIssuer
100297370MedicaidIN
2027246OtherPK

Other names 1

  • HERBST PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230330002806 IN Part B Supplier - Pharmacy 1254409337 Practice locations: Kokomo, IN

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Herbst Apothecary Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

300 E Southway Blvd
Ste E
Kokomo, IN 46902
Phone (765) 455-5418

Practitioners & affiliated clinicians

Practitioners 2

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": "1124668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709078400000",
    "number": "1295727501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E SOUTHWAY BLVD STE E",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469023678",
            "telephone_number": "765-455-5418",
            "fax_number": "765-455-5724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E SOUTHWAY BLVD STE E",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469023678",
            "telephone_number": "765-455-5418",
            "fax_number": "765-455-5724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERBST APOTHECARY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-22",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A",
        "authorized_official_last_name": "TANNER",
        "authorized_official_first_name": "HEIDI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "765-457-1191",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IN",
            "license": "60004199A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100297370",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2027246",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HERBST PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kokomo, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.