Provider Demographics
NPI:1619978061
Name:HEARTLAND HEALTH LABORATORIES, INC
Entity type:Organization
Organization Name:HEARTLAND HEALTH LABORATORIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:MCPHERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-643-4278
Mailing Address - Street 1:10435 LACKMAN RD
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66219-1221
Mailing Address - Country:US
Mailing Address - Phone:913-643-4278
Mailing Address - Fax:913-642-4282
Practice Address - Street 1:10435 LACKMAN RD
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66219-1221
Practice Address - Country:US
Practice Address - Phone:913-643-4278
Practice Address - Fax:913-642-4282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-09
Last Update Date:2010-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17D1027382291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS9004241Medicare ID - Type Unspecified