Healthcare Provider Details

I. General information

NPI: 1881301695
Provider Name (Legal Business Name): HEARTLAND PHARMACY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2022
Last Update Date: 03/20/2023
Certification Date: 03/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 35TH STREET DR SE STE 100
CEDAR RAPIDS IA
52403-1353
US

IV. Provider business mailing address

9796 VALE ST NW
COON RAPIDS MN
55433-5546
US

V. Phone/Fax

Practice location:
  • Phone: 319-449-9057
  • Fax: 319-449-9064
Mailing address:
  • Phone: 612-986-7827
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DAN BIEURANCE
Title or Position: OWNER/ PHARMACIST
Credential:
Phone: 612-986-7827