Heritage Manor - Beardstown South, LLC

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

Legal business name

HERITAGE MANOR - BEARDSTOWN SOUTH, LLC

Doing business as

Heritage Health

Practice address

8306 Saint Lukes Dr
Beardstown, IL 62618-8384

Phone

(217) 323-4055

Fax

(217) 323-9454

NPI assigned

Nov 20, 2012

Last updated

Mar 24, 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

Part of

Heritage Enterprises Inc

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

{
    "created_epoch": "1353369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458777600000",
    "number": "1598009128",
    "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": "8306 SAINT LUKES DR",
            "city": "BEARDSTOWN",
            "state": "IL",
            "postal_code": "626188384",
            "telephone_number": "217-323-4055",
            "fax_number": "217-323-9454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE MANOR - BEARDSTOWN SOUTH, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HERITAGE ENTERPRISES, INC",
        "enumeration_date": "2012-11-20",
        "last_updated": "2016-03-24",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Harlee Harris, RSA
• Marilyn Hea, LCSW
• Cassandra L Henry
• Heritage Enterprises, Inc. (Evergreen Place Supportive Living Facility)
• Heritage Manor - Beardstown East, L.L.C.
• Heritage Manor Beardstown South, LLC (Heritage Health - Beardstown)
• Julie Kathleen Hester, RSA
• Sarah Hicks, MA
• Sandra Jean Holmes
• HSHS Medical Group Inc

• Oxygen Equipment & Supplies (DME) in Beardstown, IL
• Providers in Beardstown, 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 Mar 24, 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.