HERITAGE MANOR - STAUNTON, LLC (NPI# 1538403241) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538403241 |
| Entity Type | Organization |
| Organization Name | HERITAGE MANOR - STAUNTON, LLC |
| Other Organization Name | HERITAGE HEALTH |
| Practice Address |
215 W Pennsylvania St Staunton IL 62088-1127 |
| Mailing Address |
115 W Jefferson St Suite 401 Bloomington IL 61701-3946 |
| Practice Telephone | 6186355577 |
| Practice Fax Number | 6186355580 |
| Mailing Telephone | 3098284361 |
| Mailing Fax Number | 3098295477 |
| Enumeration Date | 2012-11-19 |
| Last Update Date | 2016-04-04 |
| Authorized Official Name | DAVID M UNDERWOOD (SENIOR VP, CFO) |
| Authorized Official Telephone | 3098237135 |
| 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 |
215 W PENNSYLVANIA ST |
| City | STAUNTON |
| State | IL |
| Zip Code | 62088-1127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629069331 | Heritage Manor Staunton LLC | Skilled Nursing Facility | 215 W Pennsylvania St, Staunton, IL 62088-1127 | 2005-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609431949 | Amanda Jane Settles | Occupational Therapy Assistant | 215 Heritage Manor-staunton, Staunton, IL 62088 | 2019-05-02 |
| 1891957130 | John Batista Caldieraro IIi | Dentist | 216 W Pennsylvania, Staunton, IL 62088 | 2008-06-27 |
| 1104012129 | Emerald Glen Management | Assisted Living Facility | 18192 Renken Road, Staunton, IL 62088 | 2007-09-24 |
| 1851649388 | South Macoupin Association for Special Education | Local Education Agency (LEA) | 701 N Deneen St, Staunton, IL 62088-1015 | 2012-08-15 |
| 1528401460 | Lisa Ann Scanzoni | Occupational Therapy Assistant | 708 N Deneen St, Staunton, IL 62088-1016 | 2013-04-10 |
| 1780635375 | Staunton School Dist 6 | Local Education Agency (LEA) | 801 N Deneen St, Staunton, IL 62088-1017 | 2006-05-16 |
| 1750881629 | Christina P Lawrence | Speech-Language Pathologist | 801 N Deneen St, Staunton, IL 62088-1017 | 2018-02-17 |
| 1316071731 | Janene Marie Parmentier | Rehabilitation Practitioner | 1043 Wolf Creek Ct, Staunton, IL 62088-1087 | 2007-03-15 |
| 1093914798 | Shawn Christopher Davis | Chiropractor | 842 N Edwardsville St, Staunton, IL 62088-1156 | 2007-07-12 |
| 1427388446 | Davis Chiropractic Center, P.C. | Chiropractor | 842 N Edwardsville St, Staunton, IL 62088-1156 | 2010-01-14 |
| Find all providers in zip 62088 | ||||
| Taxonomy Code | 332BX2000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Oxygen Equipment & Supplies |
| Definition to come... |
| 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 | ||||
Please comment or provide details below to improve the information on HERITAGE MANOR - STAUNTON, LLC.
| 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.