Organization Active NPI

Heffernan Drug Inc

Doing business as Lolo Drug

  • Community/Retail Pharmacy
  • Lolo, MT
National Provider Identifier
1639435399
Registry record updated Jul 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
8859 Issued in MT
Legal business name
HEFFERNAN DRUG INC
Doing business as
Lolo Drug
Lolo Drug LLC
Practice address
103 Glacier Dr
Lolo, MT 59847-8700
Phone
(406) 273-2322
Fax
(406) 273-4208
NPI assigned
Apr 6, 2012
Last updated
Jul 3, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Corey Robert Heffernana, PHARMD
Title
Owner
Phone
(406) 273-2322

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 8859 MT Primary

Addresses

Primary practice location

103 Glacier Dr
Lolo, MT 59847-8700

Mailing address

103 Glacier Dr
Lolo, MT 59847-8700
Phone (406) 273-2322

Other identifiers 2

IdentifierTypeStateIssuer
1639435399MedicaidMT
2134770OtherPK

Other names 2

  • Lolo Drug Doing business as
  • Lolo Drug LLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190705000859 MT Part B Supplier - Mass Immunization (Roster Biller Only) 4688909120 Practice locations: Lolo, MT

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

103 Glacier Dr
Lolo, MT 59847
Phone (406) 273-2322

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1333670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783036800000",
    "number": "1639435399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 GLACIER DR",
            "city": "LOLO",
            "state": "MT",
            "postal_code": "598478700",
            "telephone_number": "406-273-2322",
            "fax_number": "406-273-4208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 GLACIER DR",
            "city": "LOLO",
            "state": "MT",
            "postal_code": "598478700",
            "telephone_number": "406-273-2322",
            "fax_number": "406-273-4208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEFFERNAN DRUG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-06",
        "last_updated": "2026-07-03",
        "certification_date": "2026-07-03",
        "status": "A",
        "authorized_official_last_name": "HEFFERNANA",
        "authorized_official_first_name": "COREY",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-273-2322",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MT",
            "license": "8859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639435399",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2134770",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lolo Drug",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lolo Drug LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lolo, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.