Hermela Demesse

Individual provider Active NPI Pharmacist · Anna, TX

NPI 1487258455 · NPPES record last updated Nov 30, 2020

Key facts

NPI
1487258455
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
58410 (TX)
Practice address
2740 W White St
Anna, TX 75409-5373
Phone
(972) 924-8686
NPI assigned
Nov 30, 2020
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
58410TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
CVS Pharmacy Inc Past
since Dec 6, 2020
Accepting new patients
CVS Pharmacy Inc Past
since Dec 6, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
183500000X 58410 TX Yes

Addresses

Primary practice location

2740 W White St
Anna, TX 75409-5373

Mailing address

2740 W White St
Anna, TX 75409-5373
Phone (972) 924-8686

Other providers in Anna, TX

All providers in Anna, TX · Pharmacist in Texas

Sources for this page

Verify at the official NPI Registry.