Organization
HEARTLAND HOME CARE LLC
Active
Other names
ProMedica Home Health (Ft. Wayne)
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BARRY A LAZARUS (VICE PRESIDENT - REIMBURSEMENTS)
(419) 252-5541
Entity
Organization
Contact information
Practice address
1315 DIRECTORS ROW, SUITE 210, FT WAYNE, IN 46808-1284
(216) 901-1464
(216) 986-0081
Mailing address
333 N SUMMIT ST, ATTN: DEAN SHIPMAN, TOLEDO, OH 43604-1531
(419) 254-7841
(419) 252-6448
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
05-005366-1
IN
251F00000X
Home Infusion Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100265250
—
IN
Enumeration date
05/17/2006
Last updated
01/23/2022
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