Organization
HEARTLAND HOME MEDICAL SUPPLY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATHERINE ROUSEY (CO-OWNER)
(309) 829-8122
Entity
Organization
Contact information
Practice address
716 E EMPIRE ST, STE 2, BLOOMINGTON, IL 61701-8613
(309) 829-8122
(309) 829-8899
Mailing address
716 E EMPIRE ST, STE 2, BLOOMINGTON, IL 61701-8613
(309) 829-8122
(309) 829-8899
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05732076
BCBS
IL
01
—
101025
HEALTH ALLIANCE
IL
Enumeration date
04/11/2006
Last updated
03/06/2012
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