Healthcare Provider Details

I. General information

NPI: 1366868135
Provider Name (Legal Business Name): HEARTLAND INFUSION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2014
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9943 KINGSTON PIKE
KNOXVILLE TN
37922
US

IV. Provider business mailing address

9943 KINGSTON PIKE
KNOXVILLE TN
37922-6923
US

V. Phone/Fax

Practice location:
  • Phone: 865-909-9713
  • Fax:
Mailing address:
  • Phone: 865-909-9713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number0000005363
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number0000005363
License Number StateTN

VIII. Authorized Official

Name: MR. WILLIAM SEIBELS
Title or Position: CFO
Credential:
Phone: 818-731-9903