Organization
HEFFERNAN DRUG INC
Active
Other names
Lolo Drug LLC, Lolo Drug
Organization subpart
No
Provider details
NPI number
Authorized official
COREY ROBERT HEFFERNANA PHARMD (OWNER)
(406) 273-2322
Entity
Organization
Contact information
Practice address
103 GLACIER DR, LOLO, MT 59847-8700
(406) 273-2322
(406) 273-4208
Mailing address
103 GLACIER DR, LOLO, MT 59847-8700
(406) 273-2322
(406) 273-4208
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
8859
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1639435399
—
MT
01
—
2134770
PK
—
Enumeration date
04/06/2012
Last updated
05/17/2020
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