Provider Demographics
NPI:1205563947
Name:HEARTLAND HEALTH CLINIC
Entity type:Organization
Organization Name:HEARTLAND HEALTH CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEETS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-879-9002
Mailing Address - Street 1:PO BOX 702
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:VA
Mailing Address - Zip Code:22821-0702
Mailing Address - Country:US
Mailing Address - Phone:540-879-9002
Mailing Address - Fax:540-879-9007
Practice Address - Street 1:101 HEARTLAND CT
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:VA
Practice Address - Zip Code:22821-9000
Practice Address - Country:US
Practice Address - Phone:540-879-9002
Practice Address - Fax:540-879-9007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-03
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy