Provider Demographics
NPI:1881893493
Name:HEARTLAND HOSPICE SERVICES, INC.
Entity type:Organization
Organization Name:HEARTLAND HOSPICE SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT - REIMBURSEMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:LAZARUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-252-5541
Mailing Address - Street 1:333 N SUMMIT ST
Mailing Address - Street 2:ATTN DEAN SHIPMAN
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-1531
Mailing Address - Country:US
Mailing Address - Phone:419-252-5500
Mailing Address - Fax:
Practice Address - Street 1:12304 BALTIMORE AVE
Practice Address - Street 2:SUITE A
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-1314
Practice Address - Country:US
Practice Address - Phone:240-264-1692
Practice Address - Fax:240-264-1696
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEARTLAND HOSPICE SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-13
Last Update Date:2022-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH1542251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD043270900Medicaid
MD04321702Medicaid
MD043271703Medicaid