Provider Demographics
NPI:1972702587
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 1:4E ROLLLING CROSSROADS
Practice Address - Street 2:SUITE 307
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228
Practice Address - Country:US
Practice Address - Phone:410-719-8670
Practice Address - Fax:410-719-0241
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:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH1533251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based