Heritage Manor - Carlinville, Llc

NPI 1093059701 - Durable Medical Equipment & Medical Supplies - 332BX2000X

NPI Details
NPI 1093059701
Enumeration Date 11/19/2012
Last Updated 11/19/2012
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name CRAIG L CRAIG
Position EXEC VP, CFO
Phone (217) 854-4433
Fax (217) 854-6291
Practice Location
1200 UNIVERSITY ST
CARLINVILLE IL, 62626-9600, US
Phone (217) 854-4433
Fax (217) 854-6291
Business Location
115 W JEFFERSON ST
SUITE 401
BLOOMINGTON IL, 61701-3946, US
Phone (309) 828-4361
Fax (309) 829-5477
Toxanomy
Taxonomy Code 332BX2000X
License State
License Number
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According to our database, Heritage Manor - Carlinville, Llc NPI is 1093059701, taxonomy code is 332BX2000X Heritage Manor - Carlinville, Llc physically located at 1200 University St, Carlinville IL, 62626-9600. NPI Number 1033115704 has the healthcare provider type.

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1093059701 NPI number is provided on an as is basis without warranty of any kind. 1093059701 is maintained by the National Plan & Provider Enumeration System. The contents of Heritage Manor - Carlinville, Llc are for informational purposes only.