Basic Information
| Provider Information | |||||||||
| NPI: | 1699890087 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | HEARTLAND HOSPICE-MCALESTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 333 N SUMMIT ST | ||||||||
| Address2: | |||||||||
| City: | TOLEDO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436041531 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8004271902 | ||||||||
| FaxNumber: | 4192545336 | ||||||||
| Practice Location | |||||||||
| Address1: | 210 E COMANCHE AVE | ||||||||
| Address2: | |||||||||
| City: | MCALESTER | ||||||||
| State: | OK | ||||||||
| PostalCode: | 745015846 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9183020700 | ||||||||
| FaxNumber: | 9183020707 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/21/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | DOTSON | ||||||||
| AuthorizedOfficialFirstName: | DOVIRN | ||||||||
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| AuthorizedOfficialTitleorPosition: | ACCOUNTS RECEIVABLE SUPERVISOR | ||||||||
| AuthorizedOfficialTelephone: | 8004271902 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251G00000X | Y | Agencies | Hospice Care, Community Based |
No ID Information.