Provider Demographics
NPI:1730164799
Name:HEIM, MARTIN III (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:
Last Name:HEIM
Suffix:III
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 VALLEY POINTE
Mailing Address - Street 2:
Mailing Address - City:RICHLANDS
Mailing Address - State:VA
Mailing Address - Zip Code:24641-2888
Mailing Address - Country:US
Mailing Address - Phone:706-566-2046
Mailing Address - Fax:276-935-4279
Practice Address - Street 1:164 CARROLL ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:VA
Practice Address - Zip Code:24266-4510
Practice Address - Country:US
Practice Address - Phone:276-889-3700
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02022072321835P1200X
GARPH0225151835P1200X
NV165931835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy