Healthcare Provider Details
I. General information
NPI: 1801509732
Provider Name (Legal Business Name): HEARTLAND HOSPICE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/05/2023
Last Update Date: 01/05/2023
Certification Date: 01/03/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3801 UNION DR STE 202
LINCOLN NE
68516-6778
US
IV. Provider business mailing address
333 N SUMMIT ST
TOLEDO OH
43604-1531
US
V. Phone/Fax
- Phone: 402-858-3700
- Fax:
- Phone: 567-585-1191
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0002X |
| Taxonomy | Hospice and Palliative Medicine (Internal Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARTIN
D
ALLEN
Title or Position: DIRECTOR
Credential:
Phone: 419-252-5734