Provider Demographics
NPI:1073090767
Name:HEARTLINE MEDICAL, INC.
Entity Type:Organization
Organization Name:HEARTLINE MEDICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HAZEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SEAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-703-1085
Mailing Address - Street 1:PO BOX 2096
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-0096
Mailing Address - Country:US
Mailing Address - Phone:770-703-1085
Mailing Address - Fax:770-731-1444
Practice Address - Street 1:6000 SHAKERAG HL STE 100
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-6523
Practice Address - Country:US
Practice Address - Phone:770-391-3000
Practice Address - Fax:770-742-0356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-25
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies