Heritage Manor - Elgin, LLC

NPI #1013251727 in Elgin, Illinois

Provider Information

NPI Number: 1013251727
Entity Type: Organization
Organization Name: Heritage Manor - Elgin, LLC
Subpart: Yes (part of a larger organization)
Parent Organization: HERITAGE ENTERPRISES, INC
Primary Specialty: Durable Medical Equipment & Medical Supplies - Oxygen Equipment & Supplies
Enumeration Date: Nov 19, 2012
Last Updated: Oct 18, 2016

Practice Location

Address: 355 RAYMOND ST
City: Elgin
State: Illinois
ZIP Code: 60120-7875
Phone: (847) 697-6636

Authorized Official

Name: DAVID UNDERWOOD, CPA
Title: EXEC VP, CFO
Phone: (309) 823-7139

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Durable Medical Equipment & Medical Supplies - Oxygen Equipment & Supplies — Oxygen Equipment & Supplies	332BX2000X	Primary

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