Healthcare Provider Details

I. General information

NPI: 1689809816
Provider Name (Legal Business Name): HEARTCARE,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2009
Last Update Date: 05/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 BUTTON LN SUITE E
LA GRANGE KY
40031-7795
US

IV. Provider business mailing address

2001 BUTTON LN SUITE E
LA GRANGE KY
40031-7795
US

V. Phone/Fax

Practice location:
  • Phone: 502-225-4712
  • Fax: 502-225-4714
Mailing address:
  • Phone: 502-225-4712
  • Fax: 502-225-4714

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSEPH MARTIN WILLINGER
Title or Position: PRESIDENT/CEO
Credential:
Phone: 502-225-4712