Provider Demographics
NPI:1215992631
Name:HEARTLAND HEMATOLOGY ONCOLOGY ASSOCIATES INC
Entity type:Organization
Organization Name:HEARTLAND HEMATOLOGY ONCOLOGY ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:T
Authorized Official - Last Name:DONOVAN
Authorized Official - Suffix:
Authorized Official - Credentials:CMPE
Authorized Official - Phone:816-455-8129
Mailing Address - Street 1:5400 N OAK TRFY
Mailing Address - Street 2:SUITE101
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64118-4688
Mailing Address - Country:US
Mailing Address - Phone:816-455-8129
Mailing Address - Fax:816-455-8128
Practice Address - Street 1:5400 N OAK TRFY
Practice Address - Street 2:SUITE101
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64118-4688
Practice Address - Country:US
Practice Address - Phone:816-455-8129
Practice Address - Fax:816-455-8128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO262950OtherFEDERAL BLACK LUNG
MO04627012OtherBCBS
MO501787501Medicaid
MO5820000AMedicare UPIN
MO501787501Medicaid
MO04627012OtherBCBS