Provider Demographics
NPI:1154992980
Name:HEBERT REXALL PHARMACY INC
Entity type:Organization
Organization Name:HEBERT REXALL PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:HEBERT
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:207-868-2242
Mailing Address - Street 1:31 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:VAN BUREN
Mailing Address - State:ME
Mailing Address - Zip Code:04785-1012
Mailing Address - Country:US
Mailing Address - Phone:207-868-2242
Mailing Address - Fax:207-868-2156
Practice Address - Street 1:31 MAIN ST
Practice Address - Street 2:
Practice Address - City:VAN BUREN
Practice Address - State:ME
Practice Address - Zip Code:04785-1012
Practice Address - Country:US
Practice Address - Phone:207-868-2242
Practice Address - Fax:207-868-2156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-02
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy