Provider Demographics
NPI:1821489899
Name:HEARTSPRING, INC
Entity Type:Organization
Organization Name:HEARTSPRING, INC
Other - Org Name:PEDIATRIC SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ATTIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PELNAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-634-8718
Mailing Address - Street 1:8700 E 29TH ST N
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-2169
Mailing Address - Country:US
Mailing Address - Phone:316-634-8710
Mailing Address - Fax:316-634-8891
Practice Address - Street 1:8700 E 29TH ST N
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-2169
Practice Address - Country:US
Practice Address - Phone:316-634-8710
Practice Address - Fax:316-634-8891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-12
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No261QA3000XAmbulatory Health Care FacilitiesClinic/CenterAugmentative Communication
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100007340BMedicaid