Organization
HEARTLAND HOSPICE SERVICES LLC
Active
Other names
ProMedica Hospice (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
(260) 484-7622
(260) 484-7619
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
251G00000X
Community Based Hospice Care Agency
Primary
07-006341-1
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200142900(A)
—
IN
05
—
200142900D
—
IN
Enumeration date
05/17/2006
Last updated
01/31/2022
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