Individual
JACQUELINE HEINEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM. D
Contact information
Practice address
2003 KOOTENAI HEALTHY WAY PHARMACY, COEUR D'ALENE, ID 83814
(208) 765-9586
Mailing address
2003 KOOTENAI HEALTHY WAY- PHARMACY, COEUR D ALENE, ID 83814
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
6281
MT
183500000X
Pharmacist
Primary
P6454
ID
183500000X
Pharmacist
PH60191857
WA
Other
Enumeration date
07/20/2012
Last updated
12/29/2016
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