HEREFORD PHARMACY, LLC (NPI# 1174782825) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174782825 |
| Entity Type | Organization |
| Organization Name | HEREFORD PHARMACY, LLC |
| Other Organization Name | HEREFORD PHARMACY |
| Practice Address |
809 S 25 Mile Ave Hereford TX 79045 |
| Mailing Address |
809 S 25 Mile Ave Hereford TX 79045-4801 |
| Practice Telephone | 8063643400 |
| Practice Fax Number | 8063643405 |
| Mailing Telephone | 8063643400 |
| Mailing Fax Number | 8063643405 |
| Enumeration Date | 2008-06-07 |
| Last Update Date | 2020-09-25 |
| Authorized Official Name | BRENT LANE DANCE (OWNER) |
| Authorized Official Telephone | 8063350729 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
26063 | TX | Suppliers |
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | 6298500001 | TX | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
26063 | TX | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICARE | 6298500001 | 01 |
| Other Name | Type Code |
|---|---|
| Hereford Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588010037 | Hereford Pharmacy, LLC | Pharmacy | 809 S 25 Mile Ave, Hereford, TX 79045-4801 | 2016-05-13 |
| Street Address |
809 S 25 MILE AVE |
| City | HEREFORD |
| State | TX |
| Zip Code | 79045 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447473012 | Brent Lane Dance | Pharmacist | 809 S 25 Mile Ave, Hereford Pharmacy, Hereford, TX 79045-4801 | 2007-04-11 |
| 1972148484 | Kimberly Dawn Montgomery | Pharmacist | 809 S 25 Mile Ave, Hereford, TX 79045-4801 | 2019-11-08 |
| 1588010037 | Hereford Pharmacy, LLC | Pharmacy | 809 S 25 Mile Ave, Hereford, TX 79045-4801 | 2016-05-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386848471 | Strategic Care of Hereford, LLC. | Skilled Nursing Facility | 231 Kingwood Street, Hereford, TX 79045 | 2007-06-12 |
| 1700965431 | Rick Roden Dds Inc | Dentist | 129 W 5th, Hereford, TX 79045 | 2006-11-03 |
| 1417054917 | Cvs Pharmacy Inc | Pharmacy | 101 West Park Ave, Hereford, TX 79045 | 2006-09-20 |
| 1396737466 | Carolyn S Jansa | Nurse Practitioner | 540 W. 15th Street, Hereford, TX 79045 | 2005-08-16 |
| 1376941682 | Kameshkumar Patel | Dentist | 701 N 25 Mile Ave, Smile Accent Pllc, Hereford, TX 79045 | 2014-12-18 |
| 1447392303 | Mary Jessica Mertins | Nurse Practitioner | 540 W. 15th Street, Hereford, TX 79045 | 2007-02-13 |
| 1780723791 | Trevor Rohm | Emergency Medicine | 540 W 15th St, Hereford, TX 79045 | 2007-02-06 |
| 1043273873 | Sean Daryl Wengroff | Obstetrics & Gynecology | 540 W 15th St, Hereford, TX 79045 | 2006-04-11 |
| 1285600957 | John E Hartin | Nurse Anesthetist, Certified Registered | 540 W 15th St, Hereford, TX 79045 | 2006-02-23 |
| 1053301234 | Carmen B Flood | Nurse Practitioner | 540 W. 15th Street, Hereford, TX 79045 | 2005-10-27 |
| Find all providers in zip 79045 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417054917 | Cvs Pharmacy Inc | Pharmacy | 101 West Park Ave, Hereford, TX 79045 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831790575 | Nextlevel Pharmaceuticals LLC | Pharmacy | 1110 Texas Pkwy, Stafford, TX 77477-6419 | 2020-11-06 |
| 1629679410 | Duehan Tran Ngo | Pharmacy | 403 W Sam Houston Pkwy N, Houston, TX 77024-4736 | 2020-11-06 |
| 1679174882 | Comanche County Medical Center Company | Pharmacy | 1870 State Hwy 36, Rising Star, TX 76471 | 2020-11-04 |
| 1629679717 | Edith Achebodt | Pharmacy | 2233 Avenue J Ste 103b, Arlington, TX 76006-5884 | 2020-11-04 |
| 1356942767 | Rxassist Pharmacy, Inc. | Pharmacy | 17020 Beaver Springs Dr Ste 8, Houston, TX 77090-2398 | 2020-11-03 |
| 1154921864 | Mbepe Health LLC | Pharmacy | 301 S 9th St Ste 121, Richmond, TX 77469-3448 | 2020-10-30 |
| 1639779366 | Mens African Investors | Pharmacy | 6355 S Peek Rd Ste 300, Katy, TX 77450-7195 | 2020-10-30 |
| 1861091977 | A Medizona Pharmacy | Pharmacy | 3700 Barker Cypress Rd, Suite 700, Houston, TX 77084 | 2020-10-20 |
| 1952900078 | Nudo Pharmacy LLC | Pharmacy | 104 Industrial Blvd Ste 201, Sugar Land, TX 77478-3174 | 2020-10-20 |
| 1194324277 | Rite Scripts Pharmacy Inc | Pharmacy | 13835 Westhollow Park Dr Apt 2805, Houston, TX 77082-1885 | 2020-10-20 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.