Heritage Manor - Staunton, LLC

NPI #1538403241 in Staunton, Illinois

Provider Information

NPI Number: 1538403241
Entity Type: Organization
Organization Name: Heritage Manor - Staunton, 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 4, 2016

Practice Location

Address: 215 W PENNSYLVANIA ST
City: Staunton
State: Illinois
ZIP Code: 62088-1127
Phone: (618) 635-5577

Authorized Official

Name: DAVID M UNDERWOOD
Title: SENIOR 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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