NPIMap

Organization Active NPI

Heartland Infustion Therapy

  • Home Infusion Therapy Pharmacy
  • Peoria, IL
National Provider Identifier
1952322901
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Infusion Therapy PharmacyTaxonomy code 3336H0001X
License
0093011339 Issued in IL
Legal business name
HEARTLAND INFUSTION THERAPY
Practice address
415 NE Saint Mark CT
Peoria, IL 61603-3716
Phone
(309) 671-2745
Fax
(309) 671-2581
NPI assigned
Jul 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Robert Gestrine
Title
Manager
Phone
(309) 671-2745

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Infusion Therapy Pharmacy 3336H0001X 0093011339 IL Primary

Addresses

Primary practice location

415 NE Saint Mark CT
Peoria, IL 61603-3716

Mailing address

415 NE Saint Mark CT
Peoria, IL 61603-3716

Other identifiers 1

IdentifierTypeStateIssuer
1470549OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • HEARTLAND INSTITUTIONAL THERAPY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Heartland Pharmacy3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

415 NE Saint Mark Ct
Peoria, IL 61603
Phone (309) 671-2745

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952322901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 NE SAINT MARK CT",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616033716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 NE SAINT MARK CT",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616033716",
            "telephone_number": "309-671-2745",
            "fax_number": "309-671-2581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND INFUSTION THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GESTRINE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "309-671-2745"
    },
    "taxonomies": [
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "IL",
            "license": "0093011339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "1470549",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HEARTLAND INSTITUTIONAL THERAPY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.