Heritage Manor - Bloomington, LLC
NPI #1275877979 in Bloomington, Illinois
Provider Information
- NPI Number
- 1275877979
- Entity Type
- Organization
- Organization Name
- Heritage Manor - Bloomington, 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
- 700 E WALNUT ST
- City
- Bloomington
- State
- Illinois
- ZIP Code
- 61701-3244
- Phone
- (309) 827-8004
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 & Supplies — Oxygen Equipment & Supplies |
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