Organization
HEREFORD PHARMACY, LLC
Active
Other names
Hereford Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA MARIE MOORE (OWNER)
(806) 995-3551
Entity
Organization
Contact information
Practice address
809 S 25 MILE AVE, HEREFORD, TX 79045
(806) 364-3400
(806) 364-3405
Mailing address
809 S 25 MILE AVE, HEREFORD, TX 79045-4801
(806) 364-3400
(806) 364-3405
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
6298500001
TX
3336C0003X
Community/Retail Pharmacy
Primary
26063
TX
3336L0003X
Long Term Care Pharmacy
26063
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6298500001
MEDICARE
—
01
—
PH0660
MEDICARE
—
Enumeration date
06/07/2008
Last updated
05/20/2024
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