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HERITAGE MANOR - LASALLE LLC NPI 1366786444


NPI Information

NPI: 1366786444
Provider Name: HERITAGE MANOR - LASALLE, LLC

Doing Business As: HERITAGE HEALTH

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

Specialization: Oxygen Equipment & Supplies

Address:
115 W JEFFERSON ST
SUITE 401
BLOOMINGTON, IL
ZIP 61701
Phone: (309) 828-4361
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HERITAGE MANOR - LASALLE, LLC is an oxygen equipment and supplies durable medical equipment medical supplies in Bloomington, IL. HERITAGE MANOR - LASALLE, LLC NPI is 1366786444. The provider is registered as an organization entity type.
The provider Is Doing Business As Heritage Health.

The provider's business location address is:

115 W JEFFERSON ST
SUITE 401
BLOOMINGTON, IL
ZIP 61701-946
Phone: (309) 828-4361
Fax: (309) 829-5477

The provider's authorized official is Craig L Ater .
The authorized official title is Exec Vp and has the following contact phone number (309) 823-7135.

The enumeration date for this NPI number is 11/15/2012 and was last updated on 11/15/2012.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1332BX2000XDurable Medical Equipment & Medical SuppliesOxygen Equipment & SuppliesYes

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

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