Provider Demographics
NPI:1316038433
Name:RIVARD, HEIDI (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:
Last Name:RIVARD
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2210 9 MILE RD
Mailing Address - Street 2:
Mailing Address - City:REMUS
Mailing Address - State:MI
Mailing Address - Zip Code:49340-9503
Mailing Address - Country:US
Mailing Address - Phone:989-772-6862
Mailing Address - Fax:989-779-4051
Practice Address - Street 1:1221 SOUTH DR
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-3258
Practice Address - Country:US
Practice Address - Phone:989-772-6862
Practice Address - Fax:989-779-4051
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302034990183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist