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NPI Code Detail

MEDICARE: HEARTLAND VILLAGE OF WESTERVILLE OH (NC), LLC

MEDICARE: HEARTLAND VILLAGE OF WESTERVILLE OH (NC), 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
1314000000XSkilled Nursing Facility1772NOH

Other Identifiers

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

General Provider Information

NPI Number : 1649214933
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEARTLAND VILLAGE OF WESTERVILLE OH (NC), LLC
Provider Business Mailing Address
First Line : 333 N SUMMIT ST
Second Line :
City : TOLEDO
State : OH
Zip : 43604-2615
Country : US
Telephone Number : 419-252-5500
Fax Number : 877-385-9446
Provider Business Practice Location Address
First Line : 1060 EASTWIND DR
Second Line :
City : WESTERVILLE
State : OH
Zip : 43081-3331
Country : US
Telephone Number : 614-895-1038
Fax Number : 614-895-1094
Authorized Official
Title or Position : DIRECTOR
Name : MR. MARTIN D ALLEN
Credential :
Telephone Number : 419-252-5734
Provider Enumeration Date : 06/16/2006
Last Update Date : 06/23/2023

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1447893375 — NICOLE STILLWAGON WALTERMYER NURSE PRACTITIONER
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1225733355 — LEGACY WESTERVILLE OPERATING COMPANY, LLC
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Directions to “HEARTLAND VILLAGE OF WESTERVILLE OH (NC), LLC ” Practice Location

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