Healthcare Provider Details

I. General information

NPI: 1750407136
Provider Name (Legal Business Name): HEARTLAND HOSPICE-NORMAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 N PORTER AVE SUITE 104
NORMAN OK
73071-6411
US

IV. Provider business mailing address

333 N SUMMIT ST
TOLEDO OH
43604-1531
US

V. Phone/Fax

Practice location:
  • Phone: 405-579-8564
  • Fax: 405-579-0192
Mailing address:
  • Phone: 800-427-1902
  • Fax: 419-254-5336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. DOVIRN DOTSON
Title or Position: ACCOUNTS RECEIVABLE SUPERVISOR
Credential:
Phone: 800-427-1902