Healthcare Provider Details

I. General information

NPI: 1871680934
Provider Name (Legal Business Name): K HEFNER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2006
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1203 FILER AVE E
TWIN FALLS ID
83301-4118
US

IV. Provider business mailing address

1203 FILER AVE E
TWIN FALLS ID
83301-4118
US

V. Phone/Fax

Practice location:
  • Phone: 208-734-8177
  • Fax: 208-734-8184
Mailing address:
  • Phone: 208-734-8177
  • Fax: 208-734-8184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number1046CP
License Number StateID

VIII. Authorized Official

Name: DR. CHRISTOPHER RAY JOHNSON
Title or Position: PRESIDENT
Credential:
Phone: 208-734-8177