Heritage Manor Chillicothe, LLC

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

Legal business name

HERITAGE MANOR CHILLICOTHE, LLC

Practice address

1028 W Hillcrest Dr
Chillicothe, IL 61523-2258

Phone

(309) 274-2194

NPI assigned

Dec 8, 2018

Organization subpart

Yes

Parent organization

HERITAGE ENTERPRISES, INC.As reported in NPPES

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

Authorized official

Name

David M Underwood

Title

Cfo

Phone

(309) 828-4361

Specialties & licenses 1

Addresses

Other names 1

• Heritage Health Doing business as

Part of

Heritage Enterprises Inc

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

{
    "created_epoch": "1544227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544227200000",
    "number": "1376014969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 W JEFFERSON ST STE 401",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013967",
            "telephone_number": "309-828-4361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1028 W HILLCREST DR",
            "city": "CHILLICOTHE",
            "state": "IL",
            "postal_code": "615232258",
            "telephone_number": "309-274-2194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE MANOR CHILLICOTHE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HERITAGE ENTERPRISES, INC.",
        "enumeration_date": "2018-12-08",
        "last_updated": "2018-12-08",
        "status": "A",
        "authorized_official_last_name": "UNDERWOOD",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "309-828-4361"
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Timothy James Freund, DDS
• Jacqueline Gill, PT, DPT
• Amanda Giltner, MS CCC-SLP/L
• Crystal Carin Hackett, MFT
• Glenna Katrina Hagan, PHARM.D.
• Heritage Manor Chillicothe, LLC
• Amanda M Hewerdine
• Highland Park CVS, L.L.C.
• Kate Joann Holler
• Horizons Healthcare Agency

• Oxygen Equipment & Supplies (DME) in Chillicothe, IL
• Providers in Chillicothe, 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 Dec 8, 2018; 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.