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General NPI Number Information
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NPI Number | 1194410530
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Entity Type | Organization
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Legal Business Name | HEARTLINKS
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Dates
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Enumeration Date | 04/11/2023
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Last Update Date | 04/28/2023
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Provider Practice Location Address
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Address Line | 204 W 2ND ST
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City | GRANDVIEW
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State | WA
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Zip | 98930-1361
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Country | US
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Telephone | 509-837-1676
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Fax | 509-837-1990
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Provider Business Mailing Address
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Address Line | 204 W 2ND ST
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City | GRANDVIEW
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State | WA
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Zip | 98930-1361
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Country | US
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Telephone | 509-837-1676
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Fax | 509-837-1990
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | SHELBY ELAINE MOORE
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Credential |
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Telephone | 509-837-1676
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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