Heritage Manor - Pana, LLC

NPI #1629312335 in Pana, Illinois

Provider Information

NPI Number: 1629312335
Entity Type: Organization
Organization Name: Heritage Manor - Pana, 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 24, 2014

Practice Location

Address: 1000 E 6TH ST
City: Pana
State: Illinois
ZIP Code: 62557-1870
Phone: (217) 562-2174

Authorized Official

Name: DAVID M UNDERWOOD, CPA
Title: SR 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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