Provider Demographics
NPI:1841361318
Name:HERBECK, EILEEN B (RPH)
Entity type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:B
Last Name:HERBECK
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75601-4717
Mailing Address - Country:US
Mailing Address - Phone:903-234-7060
Mailing Address - Fax:903-753-2249
Practice Address - Street 1:1300 N 4TH ST
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-4717
Practice Address - Country:US
Practice Address - Phone:903-234-7060
Practice Address - Fax:903-753-2249
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX234091835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology