MEDICARE: HEARTLAND HOSPICE-WEST COVINA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538285937
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEARTLAND HOSPICE-WEST COVINA

Provider Business Mailing Address
First Line	:	333 N SUMMIT ST
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43604-1531
Country	:	US
Telephone Number	:	800-427-1902
Fax Number	:	419-254-5336

Provider Business Practice Location Address
First Line	:	1000 LAKES DR
Second Line	:	SUITE 225
City	:	WEST COVINA
State	:	CA
Zip	:	91790-2900
Country	:	US
Telephone Number	:	626-918-1207
Fax Number	:	626-918-4918

Authorized Official
Title or Position	:	ACCOUNTS RECEIVABLE SUPERVISOR
Name	:	MS. DOVIRN DOTSON
Credential	:
Telephone Number	:	800-427-1902

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	08/22/2020

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Directions to “HEARTLAND HOSPICE-WEST COVINA ” Practice Location

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