Organization
HEARTLAND HOSPICE SERVICES LLC
Active
Other names
ProMedica Hospice (Warrenton), ProMedica Hospice (Fairfax)
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARTIN D ALLEN (DIRECTOR)
(419) 252-5734
Entity
Organization
Contact information
Practice address
3975 FAIR RIDGE DR STE S125, FAIRFAX, VA 22033-2924
(703) 273-8693
(703) 273-8694
Mailing address
333 N SUMMIT ST, ATTN: DEAN SHIPMAN, TOLEDO, OH 43604-2615
(419) 254-7841
(419) 252-6448
Taxonomy
Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
—
—
251G00000X
Community Based Hospice Care Agency
Primary
HSP-0768
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004910575
—
VA
Enumeration date
07/02/2006
Last updated
10/19/2023
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