Healthcare Provider Details

I. General information

NPI: 1801759568
Provider Name (Legal Business Name): KEVIN DANIEL HEILMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2905 3RD AVE SE
ABERDEEN SD
57401-5420
US

IV. Provider business mailing address

2215 N DAKOTA ST
ABERDEEN SD
57401-8100
US

V. Phone/Fax

Practice location:
  • Phone: 605-626-4780
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number7076
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: