Provider Demographics
NPI:1144325515
Name:HEARTLAND PULMONARY REHAB & OXYGEN SERVICES LLC
Entity type:Organization
Organization Name:HEARTLAND PULMONARY REHAB & OXYGEN SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:HOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-999-7710
Mailing Address - Street 1:2609 CHAPEL WOOD TER
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-5714
Mailing Address - Country:US
Mailing Address - Phone:573-445-8011
Mailing Address - Fax:573-445-8011
Practice Address - Street 1:300 PORTLAND ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-6569
Practice Address - Country:US
Practice Address - Phone:573-999-7710
Practice Address - Fax:573-445-8011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies