HERITAGE MANOR - CARLINVILLE L.L.C. NPI 1477703882

NPI Information

NPI: 1477703882
Provider Name: HERITAGE MANOR - CARLINVILLE, L.L.C.

Former Legal Business Name: HERITAGE ENTERPRISES, INC DBA HERITAGE MANOR CARLINVILLE

Classification: Durable Medical Equipment & Medical Supplies - 332BX2000X
Entity Type: Organization

Specialization: Oxygen Equipment & Supplies

Address:
1200 UNIVERSITY AVENUE
CARLINVILLE, IL
ZIP 62626
Phone: (217) 854-4433
Get Directions

HERITAGE MANOR - CARLINVILLE, L.L.C. is an oxygen equipment and supplies durable medical equipment medical supplies in Carlinville, IL. HERITAGE MANOR - CARLINVILLE, L.L.C. NPI is 1477703882. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Heritage Enterprises, Inc Dba Heritage Manor Carlinville.

The provider's business location address is:

1200 UNIVERSITY AVENUE
CARLINVILLE, IL
ZIP 62626-600
Phone: (217) 854-4433
Fax: (217) 854-6291

The provider's authorized official is Craig L. Ater .
The authorized official title is Senior Vice President Of Finance and has the following contact phone number (309) 828-4361.

The enumeration date for this NPI number is 9/22/2008 and was last updated on 2/4/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	332BX2000X	Durable Medical Equipment & Medical Supplies	Oxygen Equipment & Supplies		ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	370909086806	OTHER	ILLINOIS	PRIOR MEDICAID OXYGEN PROVIDER #

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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