Heritage Manor - Streator

NPI #1104160886 in Streator, Illinois

Provider Information

NPI Number
1104160886
Entity Type
Organization
Organization Name
Heritage Manor - Streator
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
Apr 24, 2014

Practice Location

Address
1525 E MAIN ST
ZIP Code
61364-3162
Phone
(815) 672-4516

Authorized Official

Name
DAVID M UNDERWOOD, CPA
Title
SR VP & CFO
Phone
(309) 823-7135

Specialties & Taxonomy Codes

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

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