NPIMap

Organization Active NPI

H-E-B, LP

Doing business as HEB Pharmacy #772

  • Community/Retail Pharmacy
  • Lubbock, TX
National Provider Identifier
1811519044
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
H-E-B, LP
Doing business as
HEB Pharmacy #772
Practice address
4405 114TH Street
Lubbock, TX 79424
Phone
(806) 698-6828
Fax
(806) 698-5983
NPI assigned
May 11, 2020
Last updated
Aug 9, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Authorized official

Name
David LiendoNPI 1376857813
Title
Government Programs Manager
Phone
(210) 938-3182

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
Clinical Medical Laboratory 291U00000X
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

4405 114TH Street
Lubbock, TX 79424

Mailing address

646 S Flores St
San Antonio, TX 78204-1219

Other names 1

  • HEB Pharmacy #772 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
O20210208001703 TX DME Supplier - Pharmacy 8224190871 Practice locations: Lubbock, 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
45D2195684Heb Pharmacy #7724405 114TH Street, Lubbock, TX 79424Certificate of waiverOct 11, 2026

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Heb Pharmacy #7724405 114TH St, Lubbock, TX 79424-7461(806) 698-6828 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 0041452 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 20

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 20

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": "1589155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691539200000",
    "number": "1811519044",
    "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": "4405 114TH STREET",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "79424",
            "telephone_number": "806-698-6828",
            "fax_number": "806-698-5983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "H-E-B, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-11",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A",
        "authorized_official_last_name": "LIENDO",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "GOVERNMENT PROGRAMS MANAGER",
        "authorized_official_telephone_number": "210-938-3182"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "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 #772",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HEB Pharmacy #772",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; 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.