Heritage Pharmacy Incorporated
Pharmacy, Community/Retail Pharmacy in Desoto, TX. Organization (NPI-2).
Details
- NPI
- 1255445243
- Entity type
- Organization (NPI-2)
- Legal business name
- Heritage Pharmacy Incorporated
- Organization subpart
- No
- Enumeration date
- Aug 18, 2006
- Last updated
- Apr 24, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | 23998 | TX | Yes |
Other names
- Heritage Pharmacy (Doing Business As)
Practice location
621 N. Hampton RdSte. 108
Desoto, TX 75115
Phone 469-747-3171 · Fax 469-747-3172
Mailing address
621 N. Hampton RdSte. 108
Desoto, TX 75115
Phone 469-747-3171 · Fax 469-747-3172
Authorized official
Naibon D. Moore
Managing Officer
3138197339
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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