MEDICARE: HEARTLAND HOME HEALTH CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy	54008655	IL

General Provider Information

NPI Number	:	1073594057
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEARTLAND HOME HEALTH CARE

Provider Business Mailing Address
First Line	:	221 NE GLEN OAK AVE
Second Line	:
City	:	PEORIA
State	:	IL
Zip	:	61636-0001
Country	:	US
Telephone Number	:	309-671-5151
Fax Number	:	309-671-2520

Provider Business Practice Location Address
First Line	:	221 NE GLEN OAK AVE
Second Line	:
City	:	PEORIA
State	:	IL
Zip	:	61636-0001
Country	:	US
Telephone Number	:	309-671-5151
Fax Number	:	309-671-2520

Authorized Official
Title or Position	:	PHARMACIST IN CHARGE
Name	:	LORI R KREITER
Credential	:	RPH
Telephone Number	:	309-671-5151

Provider Enumeration Date	:	11/08/2005
Last Update Date	:	08/22/2020

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Directions to “HEARTLAND HOME HEALTH CARE ” Practice Location

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