Provider Demographics
NPI:1164230710
Name:HEFFREN, JOSH (PHARMD, BCPPS)
Entity type:Individual
Prefix:
First Name:JOSH
Middle Name:
Last Name:HEFFREN
Suffix:
Gender:M
Credentials:PHARMD, BCPPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6106 ENQUIRER ST
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-2982
Mailing Address - Country:US
Mailing Address - Phone:217-828-0704
Mailing Address - Fax:
Practice Address - Street 1:111 MICHIGAN AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2916
Practice Address - Country:US
Practice Address - Phone:202-602-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-27
Last Update Date:2025-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA.00200541835E0208X
DC81512191835E0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835E0208XPharmacy Service ProvidersPharmacistEmergency Medicine