Provider Demographics
NPI:1871715789
Name:HEFFNER, CHAD RICHARD (RPH)
Entity type:Individual
Prefix:MR
First Name:CHAD
Middle Name:RICHARD
Last Name:HEFFNER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:661 MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:MILLERSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17062-9217
Mailing Address - Country:US
Mailing Address - Phone:717-953-4514
Mailing Address - Fax:
Practice Address - Street 1:27 CJEMS LN
Practice Address - Street 2:
Practice Address - City:MIFFLINTOWN
Practice Address - State:PA
Practice Address - Zip Code:17059-8384
Practice Address - Country:US
Practice Address - Phone:717-436-0172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP040182L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist