Provider Demographics
NPI:1902372246
Name:HERITAGE LLC
Entity Type:Organization
Organization Name:HERITAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHULTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-648-8086
Mailing Address - Street 1:12525 E KILLARNEY CT
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-4162
Mailing Address - Country:US
Mailing Address - Phone:316-648-8086
Mailing Address - Fax:
Practice Address - Street 1:12525 E KILLARNEY CT
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-4162
Practice Address - Country:US
Practice Address - Phone:316-648-8086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-14
Last Update Date:2018-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health