Provider Demographics
NPI:1194009779
Name:HECKMAN, JAMES J (RPH)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:J
Last Name:HECKMAN
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 1:525 FARMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-3931
Mailing Address - Country:US
Mailing Address - Phone:860-583-3638
Mailing Address - Fax:860-589-2403
Practice Address - Street 1:525 FARMINGTON AVE
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-3931
Practice Address - Country:US
Practice Address - Phone:860-583-3638
Practice Address - Fax:860-589-2403
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-30
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0005224183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist