HERITAGE MANOR - LITCHFIELD, LLC (NPI# 1710221429) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710221429 |
| Entity Type | Organization |
| Organization Name | HERITAGE MANOR - LITCHFIELD, LLC |
| Other Organization Name | HERITAGE HEALTH |
| Practice Address |
628 S Illinois Ave Litchfield IL 62056-2716 |
| Mailing Address |
115 W Jefferson St Suite 401 Bloomington IL 61701-3946 |
| Practice Telephone | 2173242153 |
| Practice Fax Number | 2173245429 |
| 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 |
628 S ILLINOIS AVE |
| City | LITCHFIELD |
| State | IL |
| Zip Code | 62056-2716 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548251382 | Heritage Manor Litchfield, LLC | Durable Medical Equipment & Medical Supplies | 628 S Illinois Ave, Litchfield, IL 62056-2716 | 2005-11-01 |
| 1407331416 | Kayleigh Kerensa Magnus | Physical Therapy Assistant | 628 S Illinois Ave, Litchfield, IL 62056-2716 | 2018-09-26 |
| 1972912111 | Christine Marie Harms | Speech-Language Pathologist | 628 S Illinois Ave, Litchfield, IL 62056-2716 | 2014-08-12 |
| 1942569306 | John Love | Speech-Language Pathologist | 628 S Illinois Ave, Litchfield, IL 62056-2716 | 2012-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851940340 | Daniel Bennett | Technician | 1007 N Jefferson St, Litchfield, IL 62056 | 2019-09-06 |
| 1841846888 | Madalyn Leann Rogers | Speech-Language Pathologist | 601 W South St., Litchfield, IL 62056 | 2019-08-15 |
| 1164780185 | Jimmy Dapog | Physical Therapist | 628 Illinois St, Litchfield, IL 62056 | 2012-04-27 |
| 1114139037 | Dental Professionals of Illinois, P.C. | Dentist | 620 West Union, Litchfield, IL 62056 | 2007-05-04 |
| 1558583096 | Affordable Dentistry Today, PC | Dentist | 515 North Monroe, Litchfield, IL 62056 | 2007-05-03 |
| 1104915867 | City of Litchfield | Ambulance | 201 East Edwards, Litchfield Ave Ambulance Service, Litchfield, IL 62056 | 2006-10-12 |
| 1033213020 | Litchfield Oncology Institute Ltd | Radiology | 1201 East Union Avenue, Litchfield, IL 62056 | 2006-09-11 |
| 1891751400 | Andrew Kamp | Physical Therapist | 1510 Old Route 66 North, Litchfield, IL 62056 | 2006-04-22 |
| 1720226442 | Patti S Durbin | Nurse Anesthetist, Certified Registered | 1215 Franciscan Drive, Anesthesia Dept, Litchfield, IL 62056 | 2009-02-03 |
| 1841388840 | Muhammad Ansari | Radiology | 1201 E Union Ave, Litchfield, IL 62056 | 2006-10-11 |
| Find all providers in zip 62056 | ||||
| Taxonomy Code | 332BX2000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Oxygen Equipment & Supplies |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548251382 | Heritage Manor Litchfield, LLC | Durable Medical Equipment & Medical Supplies | 628 S Illinois Ave, Litchfield, IL 62056-2716 | 2005-11-01 |
| 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 | LITCHFIELD |
| Zip Code | 62056 |
Please comment or provide details below to improve the information on HERITAGE MANOR - LITCHFIELD, 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.