Active NPI
Theodore Heun, PHARMACIST
- Pharmacist
- Glendale, WI
National Provider Identifier
1427455468
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 9457-40
- Practice address
- 1735 W Silver Spring Dr
Glendale, WI 53209-4400 - Phone
- (414) 247-8591
- Fax
- (414) 247-8603
- NPI assigned
- Nov 19, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 9457-40 | WI | Primary |
Addresses
Primary practice location
1735 W Silver Spring Dr
Glendale, WI 53209-4400
Mailing address
6060 N Ironwood LN
Glendale, WI 53217-4423
Phone (414) 961-8899
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9457-40 | WI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416355200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416355200000",
"number": "1427455468",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6060 N IRONWOOD LN",
"city": "GLENDALE",
"state": "WI",
"postal_code": "532174423",
"telephone_number": "414-961-8899"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1735 W SILVER SPRING DR",
"city": "GLENDALE",
"state": "WI",
"postal_code": "532094400",
"telephone_number": "414-247-8591",
"fax_number": "414-247-8603"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEUN",
"first_name": "THEODORE",
"credential": "PHARMACIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-11-19",
"last_updated": "2014-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "9457-40",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.