Heritage Manor - Carlinville, LLC

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

Legal business name

HERITAGE MANOR - CARLINVILLE, LLC

Doing business as

Heritage Health

Practice address

1200 University St
Carlinville, IL 62626-9600

Phone

(217) 854-4433

Fax

(217) 854-6291

NPI assigned

Nov 19, 2012

Last updated

Oct 18, 2016By the provider in NPPES

Organization subpart

Yes

Parent organization

HERITAGE ENTERPRISES, INCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

David Underwood, CPA

Title

Exec VP, Cfo

Phone

(309) 823-7135

Specialties & licenses 1

Addresses

Other names 1

• Heritage Health Doing business as

Tax ID family

Heritage Enterprises Inc Dba Heritage Manor Carlinville2 organizations share this tax ID, including this one

Part of

Heritage Enterprises Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Heritage Manor - Carlinville, L.L.C.

  • Oxygen Equipment & Supplies (DME)
  • Carlinville, IL
  • NPI 1477703882
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1353283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476748800000",
    "number": "1093059701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 W JEFFERSON ST",
            "address_2": "SUITE 401",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013946",
            "telephone_number": "309-828-4361",
            "fax_number": "309-829-5477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 UNIVERSITY ST",
            "city": "CARLINVILLE",
            "state": "IL",
            "postal_code": "626269600",
            "telephone_number": "217-854-4433",
            "fax_number": "217-854-6291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE MANOR - CARLINVILLE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HERITAGE ENTERPRISES, INC",
        "enumeration_date": "2012-11-19",
        "last_updated": "2016-10-18",
        "status": "A",
        "authorized_official_last_name": "UNDERWOOD",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "EXEC VP, CFO",
        "authorized_official_telephone_number": "309-823-7135",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lisa Hauter, LCSW CSADF
• Gayle M. Hebner, D.C.
• Keith T Hedrick, OD
• Cheyenne Mackenzie Hellmann
• Heritage Manor - Carlinville, L.L.C.
• Heritage Manor Carlinville, LLC (Heritage Health - Carlinville)
• Rachel Lauren Hibbard, LCSW
• High Point Residence Carlinville, LLC
• Ronald K Howard Jr., LCPC
• Austin Hubbard, D.C

• Oxygen Equipment & Supplies (DME) in Carlinville, IL
• Providers in Carlinville, IL by specialty
• Oxygen Equipment & Supplies (DME) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.