Organization
HERBST APOTHECARY, INC.
Active
Other names
Herbst Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
GREG MILLER (SEC/TRES)
(765) 457-1191
Entity
Organization
Contact information
Practice address
201 N DIXON RD, KOKOMO, IN 46901-4131
(765) 457-1191
(765) 868-3184
Mailing address
201 N DIXON RD, KOKOMO, IN 46901-4131
(765) 457-1191
(765) 868-3184
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
60002425A
IN
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100175400
—
IN
01
—
2177798
PK
—
Enumeration date
05/23/2018
Last updated
05/23/2018
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