Provider Demographics
NPI:1386771079
Name:VONGOERRES, HERBERT EDWARD (RPH)
Entity type:Individual
Prefix:MR
First Name:HERBERT
Middle Name:EDWARD
Last Name:VONGOERRES
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 TULIP DR
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-1612
Mailing Address - Country:US
Mailing Address - Phone:302-645-8686
Mailing Address - Fax:
Practice Address - Street 1:1549 SAVANNAH RD
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1611
Practice Address - Country:US
Practice Address - Phone:302-644-7840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0001800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist