Provider Demographics
NPI:1679745483
Name:HEFLE, LOUIS NMI JR
Entity Type:Individual
Prefix:MR
First Name:LOUIS
Middle Name:NMI
Last Name:HEFLE
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:428 VISTA VIEW DR
Mailing Address - Street 2:
Mailing Address - City:CEDARBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53012-9178
Mailing Address - Country:US
Mailing Address - Phone:262-377-7212
Mailing Address - Fax:
Practice Address - Street 1:12600 N PORT WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53092-3469
Practice Address - Country:US
Practice Address - Phone:262-387-8888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6877183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist