MEDICARE: HERITAGE HEARTS HOMECARE LLC

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1164288833
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HERITAGE HEARTS HOMECARE LLC

Provider Business Mailing Address
First Line	:	3025 WESTWOOD NORTHERN BLVD APT 12
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45211-3625
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2345 ASHLAND AVE # 1021
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45206-2204
Country	:	US
Telephone Number	:	513-655-0024
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KEANA EAKINS
Credential	:
Telephone Number	:	513-655-0024

Provider Enumeration Date	:	02/21/2024
Last Update Date	:	02/21/2024

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