Heimdoll Holdings Inc

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

5301011313 Issued in MI

Legal business name

HEIMDOLL HOLDINGS INC

Practice address

4365 Canal Ave SW Ste N
Suite N
Grandville, MI 49418-2697

Phone

(616) 723-9391

Fax

(616) 288-9870

NPI assigned

Jan 25, 2018

Organization subpart

No

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

Authorized official

Name

Mary Heim

Title

RPH

Phone

(616) 828-8565

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Rivertown Compounding Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1516838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516838400000",
    "number": "1992203970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4365 CANAL AVE SW STE N",
            "address_2": "SUITE N",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494182697",
            "telephone_number": "616-723-9391",
            "fax_number": "616-288-9870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4365 CANAL AVE SW STE N",
            "address_2": "SUITE N",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494182697",
            "telephone_number": "616-723-9391",
            "fax_number": "616-288-9870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEIMDOLL HOLDINGS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-25",
        "last_updated": "2018-01-25",
        "status": "A",
        "authorized_official_last_name": "HEIM",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "RPH",
        "authorized_official_telephone_number": "616-828-8565"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "MI",
            "license": "5301011313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2175505",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rivertown Compounding Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Hazel-Worley, LLMSW
• Healthy Heart Cardiology, PLC
• Erin N Heator-Dietsche, CCC-SLP
• Katherine Hedges
• Jayme Marie Heim, NP
• Heinlen Counseling PLLC
• Janice Heinlen
• Alice Ann Heitzman, BSN
• Kayla Ann Helferich, RBT
• Henderson Counseling Services

• Compounding Pharmacy in Grandville, MI
• Providers in Grandville, MI by specialty
• Compounding Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.