MEDICARE: HEARTLAND HEALTH GROUP CORP

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	251E00000X	Home Health Agency
2	251G00000X	Community Based Hospice Care Agency

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1972248847	OTHER	NV	MEDICARE PART B
2	1972248847	OTHER	NV	MEDICARE PART A
3	1972248847	OTHER	MD	MEDICARE PART A
4	1972248847	OTHER	MD	MEDICARE PART B

General Provider Information

NPI Number	:	1972248847
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEARTLAND HEALTH GROUP CORP

Provider Business Mailing Address
First Line	:	2670 CHANDLER AVE STE 4
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-4084
Country	:	US
Telephone Number	:	240-317-7224
Fax Number	:

Provider Business Practice Location Address
First Line	:	2670 CHANDLER AVE STE 4
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-4084
Country	:	US
Telephone Number	:	240-317-7224
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JONALYN BERMUDEZ
Credential	:
Telephone Number	:	702-906-0505

Provider Enumeration Date	:	05/04/2022
Last Update Date	:	11/03/2024

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Directions to “HEARTLAND HEALTH GROUP CORP ” Practice Location

Language	Start Address	Practice Location

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