Provider Demographics
NPI:1225212129
Name:HEARTLAND INDUSTRIES LA, INC
Entity Type:Organization
Organization Name:HEARTLAND INDUSTRIES LA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:R
Authorized Official - Last Name:ARBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-707-0005
Mailing Address - Street 1:111 SUSAN AVE
Mailing Address - Street 2:
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42240-4951
Mailing Address - Country:US
Mailing Address - Phone:270-707-0005
Mailing Address - Fax:270-707-0013
Practice Address - Street 1:111 SUSAN AVE
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-4951
Practice Address - Country:US
Practice Address - Phone:270-707-0005
Practice Address - Fax:270-707-0013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY274815332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies