Provider Demographics
NPI:1124272257
Name:HEARTLAND MEDICAL DISTRIBUTION, LLC
Entity type:Organization
Organization Name:HEARTLAND MEDICAL DISTRIBUTION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP MARKETING & SALES
Authorized Official - Prefix:MR
Authorized Official - First Name:DUANE
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:KUNZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-284-3444
Mailing Address - Street 1:1108 HOWELL ST S
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55116-2526
Mailing Address - Country:US
Mailing Address - Phone:612-284-3444
Mailing Address - Fax:952-392-9924
Practice Address - Street 1:1108 HOWELL ST S
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55116-2526
Practice Address - Country:US
Practice Address - Phone:612-284-3444
Practice Address - Fax:952-392-9924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-17
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies