Heritage Manor - Peru, LLC

NPI #1164766861 in Peru, Illinois

Provider Information

NPI Number: 1164766861
Entity Type: Organization
Organization Name: Heritage Manor - Peru, 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: Apr 18, 2022

Practice Location

Address: 1301 21ST ST
City: Peru
State: Illinois
ZIP Code: 61354-1359
Phone: (815) 223-4901

Authorized Official

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

Specialties & Taxonomy Codes

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

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