Heritage Manor - Carlinville, LLC

NPI #1093059701 in Carlinville, Illinois

Provider Information

NPI Number
1093059701
Entity Type
Organization
Organization Name
Heritage Manor - Carlinville, 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
1200 UNIVERSITY ST
ZIP Code
62626-9600
Phone
(217) 854-4433

Authorized Official

Name
DAVID UNDERWOOD, CPA
Title
EXEC VP, CFO
Phone
(309) 823-7135

Specialties & Taxonomy Codes

Specialty
Durable Medical Equipment & Medical Supplies - Oxygen Equipment & SuppliesOxygen Equipment & Supplies

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Provider Name
Heritage Manor - Carlinville, L.l.c.

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