Provider Demographics
NPI:1629065560
Name:HEARTLAND MEDICAL AND HOME HEALTH EQUIPMENT,INC.
Entity Type:Organization
Organization Name:HEARTLAND MEDICAL AND HOME HEALTH EQUIPMENT,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEFANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:EDNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-243-5551
Mailing Address - Street 1:PO BOX 445
Mailing Address - Street 2:
Mailing Address - City:ELK CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73648-0445
Mailing Address - Country:US
Mailing Address - Phone:580-243-5551
Mailing Address - Fax:580-243-5552
Practice Address - Street 1:100 ACCESS RD
Practice Address - Street 2:
Practice Address - City:ELK CITY
Practice Address - State:OK
Practice Address - Zip Code:73644-2929
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:2005-10-05
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100811760BMedicaid
OK100811760AMedicaid
OK100634310AMedicaid
OK100811760AMedicaid