Provider Demographics
NPI:1548986466
Name:HERITAGE VET PARTNERS
Entity type:Organization
Organization Name:HERITAGE VET PARTNERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:VANDEN HEUVEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:800-480-2474
Mailing Address - Street 1:51 W FERNAU AVE
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54901-1217
Mailing Address - Country:US
Mailing Address - Phone:800-480-2474
Mailing Address - Fax:920-748-1267
Practice Address - Street 1:51 W FERNAU AVE
Practice Address - Street 2:
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54901-1217
Practice Address - Country:US
Practice Address - Phone:800-480-2474
Practice Address - Fax:920-748-1267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-12
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy