Organization
HERITAGE PHARMACY INCORPORATED
Active
Organization
HERITAGE PHARMACY INCORPORATED
Active
Other names
HERITAGE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NAIBON D. MOORE (MANAGING OFFICER)
(313) 819-7339
Entity
Organization
Contact information
Practice address
621 N. HAMPTON RD, STE. 108, DESOTO, TX 75115
(469) 747-3171
(469) 747-3172
Mailing address
621 N. HAMPTON RD, STE. 108, DESOTO, TX 75115
(469) 747-3171
(469) 747-3172
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
23998
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145508
—
TX
01
—
2096860
PK
—
Enumeration date
08/18/2006
Last updated
04/24/2019
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up