Provider Demographics
NPI:1023367315
Name:HEINEY, JOEL (PHARMD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:HEINEY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:663 ALEXIA CT
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81505-4828
Mailing Address - Country:US
Mailing Address - Phone:913-515-3628
Mailing Address - Fax:
Practice Address - Street 1:2901 F RD
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81504-5440
Practice Address - Country:US
Practice Address - Phone:970-248-9871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-03
Last Update Date:2012-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO19638183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist