HERITAGE MANOR - CARLINVILLE, LLC (NPI# 1093059701) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093059701 |
| Entity Type | Organization |
| Organization Name | HERITAGE MANOR - CARLINVILLE, LLC |
| Other Organization Name | HERITAGE HEALTH |
| Practice Address |
1200 University St Carlinville IL 62626-9600 |
| Mailing Address |
115 W Jefferson St Suite 401 Bloomington IL 61701-3946 |
| Practice Telephone | 2178544433 |
| Practice Fax Number | 2178546291 |
| Mailing Telephone | 3098284361 |
| Mailing Fax Number | 3098295477 |
| Enumeration Date | 2012-11-19 |
| Last Update Date | 2016-10-18 |
| Authorized Official Name | DAVID UNDERWOOD (EXEC VP, CFO) |
| Authorized Official Telephone | 3098237135 |
| Authorized Official Credential | CPA |
| Is Organization Subpart | Y |
| Parent Organization Name | HERITAGE ENTERPRISES, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332BX2000X |
Durable Medical Equipment & Medical Supplies Specialization: Oxygen Equipment & Supplies |
Suppliers |
| Other Name | Type Code |
|---|---|
| Heritage Health | Doing Business As Name - Organization |
| Street Address |
1200 UNIVERSITY ST |
| City | CARLINVILLE |
| State | IL |
| Zip Code | 62626-9600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093314080 | Cheyenne Mackenzie Hellmann | Physical Therapy Assistant | 1200 University St, Carlinville, IL 62626-9600 | 2020-10-20 |
| 1265041297 | Sarah Myers-eller | Occupational Therapy Assistant | 1200 University St, Carlinville, IL 62626-9600 | 2020-07-27 |
| 1912532961 | Courtney Lynn Waters | Physical Therapy Assistant | 1200 University St, Carlinville, IL 62626-9600 | 2020-03-10 |
| 1932763562 | Makinze Dc Cox | Occupational Therapy Assistant | 1200 University St, Carlinville, IL 62626-9600 | 2019-04-29 |
| 1992113732 | Joan Brown | Physical Therapy Assistant | 1200 University St, Carlinville, IL 62626-9600 | 2014-07-24 |
| 1710394754 | Jill Christine Miller | Occupational Therapy Assistant | 1200 University St, Carlinville, IL 62626-9600 | 2014-07-22 |
| 1093068421 | James Tiburzi | Speech-Language Pathologist | 1200 University St, Carlinville, IL 62626-9600 | 2012-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710521984 | Cottages At Carlinville, Inc | Assisted Living Facility | 18804 Rt. 4, Carlinville, IL 62626 | 2019-10-31 |
| 1184266348 | Susan Lynne Fite | Pharmacist | 18600 Shipman Blacktop Road, Carlinville, IL 62626 | 2019-10-09 |
| 1669013215 | Rebecca Lynn Sanson | Pharmacist | 18600 Shipman Blacktop, Carlinville, IL 62626 | 2019-10-04 |
| 1497396048 | Jill Louise Kasting | Pharmacist | 18600 Shipman Blacktop Rd, Carlinville, IL 62626 | 2019-10-04 |
| 1134561822 | Fenton Family Chiropractic PC | Chiropractor | 490 West Side Square, Carlinville, IL 62626 | 2013-07-23 |
| 1992020499 | Carlinville Area Hospital Association | Clinic/Center | 1115 Morgan Street #2, Carlinville, IL 62626 | 2010-03-29 |
| 1730213026 | Carlinville Medical Clinic, Inc. | Nurse Practitioner | 604 N. Broad, Carlinville, IL 62626 | 2007-03-16 |
| 1720155906 | Rodney Lee Bailey | Dentist | 201 Mccausland, Suite A, Carlinsville, IL 62626 | 2006-11-30 |
| 1255412599 | Nicolas E Kravanya Dmd LLC | Dentist | 204 Oakland Ave, Carlinville, IL 62626 | 2006-10-17 |
| 1558456210 | Locust Street Resource Center | Clinic/Center | 320 South Locust Street, Carlinville, IL 62626 | 2006-10-04 |
| Find all providers in zip 62626 | ||||
| Taxonomy Code | 332BX2000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Oxygen Equipment & Supplies |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477703882 | Heritage Manor - Carlinville, L.L.C. | Durable Medical Equipment & Medical Supplies | 1200 University Avenue, Carlinville, IL 62626-9600 | 2008-09-22 |
| 1831180892 | Heritage Manor Carlinville, LLC | Durable Medical Equipment & Medical Supplies | 1200 University Ave., Carlinville, IL 62626-9600 | 2005-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821699026 | First Choice Medical Equipment, Inc | Durable Medical Equipment & Medical Supplies | 65 S 65th St Ste 10, Belleville, IL 62223-2946 | 2020-11-04 |
| 1619596624 | Gz Service Inc | Durable Medical Equipment & Medical Supplies | 576 Jennifer Cir, Mundelein, IL 60060-4110 | 2020-04-09 |
| 1528690526 | Nationwide Medical, Inc. | Durable Medical Equipment & Medical Supplies | 415 W Golf Rd Ste 48, Arlington Heights, IL 60005-3923 | 2020-02-07 |
| 1477024347 | Karma7 Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 1840 Industrial Dr Ste 160, Libertyville, IL 60048-9400 | 2018-12-17 |
| 1700354354 | True Respiratory Care & Medical Management LLC | Durable Medical Equipment & Medical Supplies | 11415 183rd Pl Ste B, Orland Park, IL 60467-5011 | 2018-11-12 |
| 1467951699 | Sarah Bush Lincoln Health Center | Durable Medical Equipment & Medical Supplies | 903 N Maple St, Effingham, IL 62401 | 2018-02-02 |
| 1215436449 | Sarah Bush Lincoln Health Center | Durable Medical Equipment & Medical Supplies | 300 Coles Centre Pkwy, Mattoon, IL 61938 | 2018-02-02 |
| 1669992665 | Easy Oxygen Inc. | Durable Medical Equipment & Medical Supplies | 1862 E Belvidere Road #125, Grayslake, IL 60030 | 2017-06-21 |
| 1487103560 | The Elms | Durable Medical Equipment & Medical Supplies | 1212 Madelyn Ave, Macomb, IL 61455-3324 | 2016-09-29 |
| 1457807257 | Genventures Inc | Durable Medical Equipment & Medical Supplies | 101 S. College Avenue, Aledo, IL 61231-1630 | 2016-08-31 |
| Find all providers with the same taxonomy | ||||
| City | CARLINVILLE |
| Zip Code | 62626 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.