HERITAGE MANOR - NORMAL NPI 1841534625

NPI Information

NPI: 1841534625
Provider Name: HERITAGE MANOR - NORMAL

Doing Business As: HERITAGE HEALTH

Classification: Durable Medical Equipment & Medical Supplies - 332BX2000X
Entity Type: Organization

Specialization: Oxygen Equipment & Supplies

Address:
509 N ADELAIDE ST
NORMAL, IL
ZIP 61761
Phone: (309) 452-7468
Get Directions

HERITAGE MANOR - NORMAL is an oxygen equipment and supplies durable medical equipment medical supplies in Normal, IL. HERITAGE MANOR - NORMAL NPI is 1841534625. The provider is registered as an organization entity type.
The provider Is Doing Business As Heritage Health.

The provider's business location address is:

509 N ADELAIDE ST
NORMAL, IL
ZIP 61761-422
Phone: (309) 452-7468
Fax: (309) 862-3148

The provider's authorized official is David Underwood .
The authorized official title is Exec Vp, Cfo and has the following contact phone number (309) 823-7135.

The CLIA number assigned to this NPI record is 14D0432538 - skilled nursing facility/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/19/2012 and was last updated on 10/18/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	332BX2000X	Durable Medical Equipment & Medical Supplies	Oxygen Equipment & Supplies			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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