Provider Demographics
NPI:1083764401
Name:HEARTLAND MEDICAL AND HOME HEALTH INC
Entity Type:Organization
Organization Name:HEARTLAND MEDICAL AND HOME HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:SCHRECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-243-5551
Mailing Address - Street 1:121 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ELK CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73644-4751
Mailing Address - Country:US
Mailing Address - Phone:580-243-5551
Mailing Address - Fax:580-243-5552
Practice Address - Street 1:121 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ELK CITY
Practice Address - State:OK
Practice Address - Zip Code:73644-4751
Practice Address - Country:US
Practice Address - Phone:580-243-5551
Practice Address - Fax:580-243-5552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK35-45343336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1629065560Medicare UPIN
OK1135290001Medicare NSC