Provider Demographics
NPI:1326025412
Name:HEARTLAND RADIOLOGY, INC.
Entity Type:Organization
Organization Name:HEARTLAND RADIOLOGY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ALMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-222-7441
Mailing Address - Street 1:PO BOX 459
Mailing Address - Street 2:
Mailing Address - City:POPLAR BLUFF
Mailing Address - State:MO
Mailing Address - Zip Code:63902-0459
Mailing Address - Country:US
Mailing Address - Phone:573-222-7441
Mailing Address - Fax:573-222-7441
Practice Address - Street 1:221 PHYSICIANS PARK
Practice Address - Street 2:
Practice Address - City:POPLAR BLUFF
Practice Address - State:MO
Practice Address - Zip Code:63901-3956
Practice Address - Country:US
Practice Address - Phone:573-727-9080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-29
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR142630002Medicaid
222143OtherHEALTHLINK INC.
MO241702646Medicaid
MODO3729OtherRAILROAD MEDICARE
MO130569OtherBCBS
1600702OtherUNITED HEALTHCARE
655009OtherFIRST HEALTH
MOCH4567OtherRAILROAD MEDICARE
1600702OtherUNITED HEALTHCARE