MEDICARE: HEARTLAND MEDICAL AND HOME HEALTH INC

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	3336C0004X	Compounding Pharmacy	35-4534	OK

General Provider Information

NPI Number	:	1083764401
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEARTLAND MEDICAL AND HOME HEALTH INC

Provider Business Mailing Address
First Line	:	121 N MAIN ST
Second Line	:
City	:	ELK CITY
State	:	OK
Zip	:	73644-4751
Country	:	US
Telephone Number	:	580-243-5551
Fax Number	:	580-243-5552

Provider Business Practice Location Address
First Line	:	121 N MAIN ST
Second Line	:
City	:	ELK CITY
State	:	OK
Zip	:	73644-4751
Country	:	US
Telephone Number	:	580-243-5551
Fax Number	:	580-243-5552

Authorized Official
Title or Position	:	OWNER
Name	:	SHERRI ELAINE SCHRECK
Credential	:
Telephone Number	:	580-243-5551

Provider Enumeration Date	:	01/10/2007
Last Update Date	:	08/22/2020

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