Provider Demographics
NPI:1366868135
Name:HEARTLAND INFUSION, LLC
Entity Type:Organization
Organization Name:HEARTLAND INFUSION, LLC
Other - Org Name:HEARTLAND INFUSION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:SINGELYN
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:818-731-9903
Mailing Address - Street 1:9943 KINGSTON PIKE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-6923
Mailing Address - Country:US
Mailing Address - Phone:865-909-9713
Mailing Address - Fax:
Practice Address - Street 1:9943 KINGSTON PIKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922
Practice Address - Country:US
Practice Address - Phone:865-909-9713
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-17
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000005363261QI0500X, 3336H0001X
332B00000X, 332BP3500X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1534157AMedicaid
2145274OtherPK