# HEARTLAND DIABETIC SUPPLIES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396830980
- **Authorized official:** MS. LORA LYNN MORA (OWNER)
- **Authorized official phone:** (913) 538-7582

## Contact information

- **Practice address:** 10703 W. 149TH STREET, OVERLAND PARK, KS 66221
- **Practice address phone:** (913) 538-7582
- **Practice address fax:** (913) 897-7709
- **Mailing address:** 10703 W. 149TH STREET, OVERLAND PARK, KS 66221
- **Mailing address phone:** (913) 538-7582
- **Mailing address fax:** (913) 897-7709

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332900000X | Non-Pharmacy Dispensing Site | 6-00316 | KS | Yes |

## Other

- **Enumeration date:** 10/03/2006
- **Last updated:** 07/21/2022