Healthcare Provider Details

I. General information

NPI: 1770535858
Provider Name (Legal Business Name): HEARTLAND HOSPICE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 01/23/2022
Certification Date: 01/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 PRIDES CROSSING STE 110
NEWARK DE
19713-6107
US

IV. Provider business mailing address

333 N SUMMIT ST ATTN: DEAN SHIPMAN
TOLEDO OH
43604-2615
US

V. Phone/Fax

Practice location:
  • Phone: 302-737-7080
  • Fax: 302-737-7282
Mailing address:
  • Phone: 419-254-7841
  • Fax: 419-252-6448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License NumberHSPC-008
License Number StateDE

VIII. Authorized Official

Name: MR. MARTIN D ALLEN
Title or Position: DIRECTOR
Credential:
Phone: 419-252-5734