Provider Demographics
NPI:1770512667
Name:HEARTLAND HOME CARE LLC
Entity Type:Organization
Organization Name:HEARTLAND HOME CARE LLC
Other - Org Name:HEARTLAND HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT - REIMBURSEMENTS
Authorized Official - Prefix:MR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:LAZARUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-252-5541
Mailing Address - Street 1:333 N SUMMIT ST
Mailing Address - Street 2:ATTN: DEAN SHIPMAN
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-1531
Mailing Address - Country:US
Mailing Address - Phone:419-254-7841
Mailing Address - Fax:419-252-6448
Practice Address - Street 1:2800 ELECTRIC RD
Practice Address - Street 2:SUITE 105-C
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-3549
Practice Address - Country:US
Practice Address - Phone:540-725-7600
Practice Address - Fax:540-725-5144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004971001Medicaid
VA497544Medicare Oscar/Certification