Provider Demographics
NPI:1942476577
Name:HEARTLAND MEDICAL SUPPLIES
Entity Type:Organization
Organization Name:HEARTLAND MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DENIS
Authorized Official - Middle Name:OWEN
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:I
Authorized Official - Credentials:
Authorized Official - Phone:270-531-6565
Mailing Address - Street 1:41 RAILROAD CIR
Mailing Address - Street 2:
Mailing Address - City:BONNIEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42713-8467
Mailing Address - Country:US
Mailing Address - Phone:270-531-6565
Mailing Address - Fax:
Practice Address - Street 1:41 RAILROAD CIR
Practice Address - Street 2:
Practice Address - City:BONNIEVILLE
Practice Address - State:KY
Practice Address - Zip Code:42713-8467
Practice Address - Country:US
Practice Address - Phone:270-531-6565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-04
Last Update Date:2008-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care