Provider Demographics
NPI:1679182026
Name:HERITAGE ACQUISITION, LLC.
Entity Type:Organization
Organization Name:HERITAGE ACQUISITION, LLC.
Other - Org Name:HERITAGE HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:BEARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-840-7775
Mailing Address - Street 1:2028 E MEMORIAL RD
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-5515
Mailing Address - Country:US
Mailing Address - Phone:405-840-7775
Mailing Address - Fax:
Practice Address - Street 1:114 S 4TH ST
Practice Address - Street 2:
Practice Address - City:HENRYETTA
Practice Address - State:OK
Practice Address - Zip Code:74437-5273
Practice Address - Country:US
Practice Address - Phone:918-652-3919
Practice Address - Fax:918-652-2619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-30
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based