Healthcare Provider Details

I. General information

NPI: 1679943229
Provider Name (Legal Business Name): HERITAGE BIOLOGICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2015
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 NW VICTORIA DR STE B
LEES SUMMIT MO
64086-4709
US

IV. Provider business mailing address

255 NW VICTORIA DR STE B
LEES SUMMIT MO
64086-4709
US

V. Phone/Fax

Practice location:
  • Phone: 855-937-7273
  • Fax: 844-402-3945
Mailing address:
  • Phone: 816-875-5101
  • Fax: 844-402-3945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: BRIANNA KALEIKAU
Title or Position: SR. DIRECTOR OF QUALITY
Credential:
Phone: 816-875-5256