Provider Demographics
NPI:1932397494
Name:HEARTLAND FAMILY HEALTHCARE
Entity Type:Organization
Organization Name:HEARTLAND FAMILY HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-782-2510
Mailing Address - Street 1:407 S CLAIRBORNE RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-1723
Mailing Address - Country:US
Mailing Address - Phone:913-782-2510
Mailing Address - Fax:
Practice Address - Street 1:407 S CLAIRBORNE RD
Practice Address - Street 2:SUITE 104
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1723
Practice Address - Country:US
Practice Address - Phone:913-782-2510
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-10
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS24833305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1922026145OtherNPI NUMBER-PHYSICIAN
KSF72126Medicare UPIN
KS1922026145OtherNPI NUMBER-PHYSICIAN