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General NPI Number Information
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NPI Number | 1164475836
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Entity Type | Organization
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Legal Business Name | HEARTLAND HOSPICE SERVICES LLC
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 12/04/2015
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Provider Practice Location Address
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Address Line | 2872 N. RIDGE ROAD, SUITE 122
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City | WICHITA
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State | KS
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Zip | 67205-1144
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Country | US
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Telephone | 316-788-7626
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Fax | 316-788-8911
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Provider Business Mailing Address
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Address Line | 333 N SUMMIT ST ATTN DEAN SHIPMAN
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City | TOLEDO
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State | OH
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Zip | 43604-1531
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Country | US
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Telephone | 419-254-7841
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Fax | 419-252-6448
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. MARTIN D ALLEN
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Credential |
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Telephone | 419-252-5734
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | Z087003
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License Number State | KS
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