Organization
HEARTLAND HOSPICE SERVICES, LLC
Active
Other names
ProMedica Hospice (Green Bay)
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN DAVID ALLEN (SOLE DIRECTOR)
(419) 252-5734
Entity
Organization
Contact information
Practice address
1145 W MAIN AVE STE 205, DE PERE, WI 54115-1698
(920) 336-6455
Mailing address
PO BOX 10086, TOLEDO, OH 43699-0086
(567) 585-1191
Taxonomy
Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43189200
—
WI
Enumeration date
05/05/2022
Last updated
05/05/2022
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