Heritage Manor - Gillespie, LLC

Organization Active NPI Oxygen Equipment & Supplies (DME) · Gillespie, IL

NPI 1801130513 · NPPES record last updated Oct 18, 2016

Key facts

NPI
1801130513
Entity type
Organization (NPI type 2)
Primary specialty
Oxygen Equipment & Supplies (DME) 332BX2000X
Legal business name
HERITAGE MANOR - GILLESPIE, LLC
Practice address
7588 Staunton Rd
Gillespie, IL 62033-3232
Phone
(217) 839-2171
Fax
(217) 839-1372
NPI assigned
Nov 19, 2012
Organization subpart
Yes
Parent organization (as reported)
HERITAGE ENTERPRISES, INC

Authorized official

Name
David Underwood, CPA
Title
Exec VP, Cfo
Phone
(309) 823-7135

National Provider Directory

Part of
Heritage Enterprises Inc

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Oxygen Equipment & Supplies (DME) 332BX2000X Yes

Addresses

Primary practice location

7588 Staunton Rd
Gillespie, IL 62033-3232

Mailing address

115 W Jefferson St
Suite 401
Bloomington, IL 61701-3946
Phone (309) 828-4361

Other names

  • Heritage Health Doing business as

Other providers in Gillespie, IL

All providers in Gillespie, IL · Oxygen Equipment & Supplies (DME) in Illinois

Sources for this page

Verify at the official NPI Registry.