HERITAGE MANOR - BLOOMINGTON LLC NPI 1275877979

NPI Information

NPI: 1275877979
Provider Name: HERITAGE MANOR - BLOOMINGTON, LLC

Doing Business As: HERITAGE HEALTH

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

Specialization: Oxygen Equipment & Supplies

Address:
700 E WALNUT ST
BLOOMINGTON, IL
ZIP 61701
Phone: (309) 827-8004
Get Directions

HERITAGE MANOR - BLOOMINGTON, LLC is an oxygen equipment and supplies durable medical equipment medical supplies in Bloomington, IL. HERITAGE MANOR - BLOOMINGTON, LLC NPI is 1275877979. The provider is registered as an organization entity type.
The provider Is Doing Business As Heritage Health.

The provider's business location address is:

700 E WALNUT ST
BLOOMINGTON, IL
ZIP 61701-244
Phone: (309) 827-8004
Fax: (309) 827-0256

The provider's authorized official is David Underwood .
The authorized official title is Exec Vp, Cfo and has the following contact phone number (309) 823-7135.

The enumeration date for this NPI number is 11/19/2012 and was last updated on 10/18/2016.

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			Yes

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: 11/14/2023

NPI Synchronization or Removal

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