Healthcare Provider Details

I. General information

NPI: 1346290996
Provider Name (Legal Business Name): HERITAGE MEDICAL EQUIPMENT AND SUPPLIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

624 S ROOSEVELT AVE
BURLINGTON IA
52601
US

IV. Provider business mailing address

PO BOX 1440
BURLINGTON IA
52601-8440
US

V. Phone/Fax

Practice location:
  • Phone: 319-768-4300
  • Fax: 319-753-3693
Mailing address:
  • Phone: 319-768-4300
  • Fax: 319-753-3693

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number203.000124
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number203.000134
License Number StateIL

VIII. Authorized Official

Name: JEREMY ALEXANDER
Title or Position: CEO
Credential:
Phone: 319-768-3280