Individual
MR. CARL MICHAEL HEINEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
556 NORTHFIELD RD, WATERTOWN, CT 06795-1503
(860) 417-3471
Mailing address
256 BUNKER HILL AVE, WATERBURY, CT 06708-2253
(203) 574-7825
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
4866
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004027306
—
CT
Enumeration date
05/14/2018
Last updated
05/14/2018
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