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General NPI Number Information
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NPI Number | 1720011190
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Entity Type | Organization
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Legal Business Name | HEFFERNAN DRUG INC
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 918 SW HIGGINS AVE
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City | MISSOULA
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State | MT
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Zip | 59803-3606
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Country | US
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Telephone | 406-549-4125
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Fax | 406-549-8310
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Provider Business Mailing Address
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Address Line | 918 SW HIGGINS AVE
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City | MISSOULA
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State | MT
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Zip | 59803-0000
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Country | US
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Telephone | 406-549-4125
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Fax | 406-549-8310
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Authorized Official
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Title or Position | PRESIDENT
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Name | COREY ROBERT HEFFERNAN
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Credential |
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Telephone | 406-273-2322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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