MEDICARE: K HEFNER, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	3336C0003X	Community/Retail Pharmacy	1046CP	ID
3	1835P2201X	Ambulatory Care Pharmacist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871680934
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	K HEFNER, INC

Provider Business Mailing Address
First Line	:	1203 FILER AVE E
Second Line	:
City	:	TWIN FALLS
State	:	ID
Zip	:	83301-4118
Country	:	US
Telephone Number	:	208-734-8177
Fax Number	:	208-734-8184

Provider Business Practice Location Address
First Line	:	1203 FILER AVE E
Second Line	:
City	:	TWIN FALLS
State	:	ID
Zip	:	83301-4118
Country	:	US
Telephone Number	:	208-734-8177
Fax Number	:	208-734-8184

Authorized Official
Title or Position	:	PHARMACIST
Name	:	DR. SEAN STAYNER PARRISH
Credential	:	PHARMD
Telephone Number	:	208-420-0598

Provider Enumeration Date	:	10/09/2006
Last Update Date	:	11/17/2025

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Directions to “K HEFNER, INC ” Practice Location

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