Provider Demographics
NPI:1780631176
Name:HEARTLAND HOMECARE SERVICES INC
Entity Type:Organization
Organization Name:HEARTLAND HOMECARE SERVICES INC
Other - Org Name:HEARTLAND HOMECARE SERVICES INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:LASHLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-617-7312
Mailing Address - Street 1:1025 N 3RD ST
Mailing Address - Street 2:STE 110
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-1429
Mailing Address - Country:US
Mailing Address - Phone:785-331-0807
Mailing Address - Fax:785-331-0878
Practice Address - Street 1:1025 N 3RD ST
Practice Address - Street 2:STE 110
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-1429
Practice Address - Country:US
Practice Address - Phone:785-331-0807
Practice Address - Fax:785-331-0878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-30
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003004042332B00000X
KS2-100733336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS3000395576001Medicaid
KS30003955760002Medicaid
2026499OtherPK
KS100442900AMedicaid
MO608877205Medicaid