MEDICARE: HEARTLAND HOSPICE SERVICES, 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	207RH0002X	Hospice and Palliative Medicine (Internal Medicine) Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366171902
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEARTLAND HOSPICE SERVICES, LLC

Provider Business Mailing Address
First Line	:	333 N SUMMIT ST
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43604-1531
Country	:	US
Telephone Number	:	567-585-1191
Fax Number	:

Provider Business Practice Location Address
First Line	:	6500 BUSCH BLVD STE 210
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43229-1738
Country	:	US
Telephone Number	:	614-840-9856
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MARTIN DAVID ALLEN
Credential	:
Telephone Number	:	419-252-5734

Provider Enumeration Date	:	06/08/2022
Last Update Date	:	06/08/2022

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Directions to “HEARTLAND HOSPICE SERVICES, LLC ” Practice Location

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