Provider Demographics
NPI:1578385381
Name:HEREFORD PHARMACY INC
Entity type:Organization
Organization Name:HEREFORD PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:PFAFF
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:410-329-6209
Mailing Address - Street 1:216 MOUNT CARMEL RD
Mailing Address - Street 2:
Mailing Address - City:PARKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21120-9725
Mailing Address - Country:US
Mailing Address - Phone:410-329-6209
Mailing Address - Fax:410-357-8002
Practice Address - Street 1:216 MOUNT CARMEL RD
Practice Address - Street 2:
Practice Address - City:PARKTON
Practice Address - State:MD
Practice Address - Zip Code:21120-9725
Practice Address - Country:US
Practice Address - Phone:410-329-6209
Practice Address - Fax:410-357-8002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-31
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy