HERITAGE MANOR - MENDOTA, LLC (NPI# 1982948683) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982948683 |
| Entity Type | Organization |
| Organization Name | HERITAGE MANOR - MENDOTA, LLC |
| Other Organization Name | HERITAGE HEALTH - MENDOTA |
| Practice Address |
1201 1st Ave Mendota IL 61342-1815 |
| Mailing Address |
115 W Jefferson St Suite 401 Bloomington IL 61701-3946 |
| Practice Telephone | 8155396745 |
| Practice Fax Number | 8155382017 |
| Mailing Telephone | 3098284361 |
| Mailing Fax Number | 3098295477 |
| Enumeration Date | 2012-11-19 |
| Last Update Date | 2014-04-24 |
| Authorized Official Name | DAVID M UNDERWOOD (SR. VP, CFO) |
| Authorized Official Telephone | 3098237135 |
| Authorized Official Credential | CPA |
| Is Organization Subpart | Y |
| Parent Organization Name | HERITAGE ENTERPRISES, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332BX2000X |
Durable Medical Equipment & Medical Supplies Specialization: Oxygen Equipment & Supplies |
Suppliers |
| Other Name | Type Code |
|---|---|
| Heritage Health - Mendota | Doing Business As Name - Organization |
| Street Address |
1201 1ST AVE |
| City | MENDOTA |
| State | IL |
| Zip Code | 61342-1815 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871583906 | Heritage Manor Mendota, LLC | Durable Medical Equipment & Medical Supplies | 1201 1st Ave, Mendota, IL 61342-1815 | 2005-10-28 |
| 1265046213 | Tamara Marie Morris | Occupational Therapy Assistant | 1201 1st Ave, Mendota, IL 61342-1815 | 2020-09-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568536845 | Keri Sundberg | Dentist | 709 Plaza Drive, Mendota, IL 61342 | 2006-11-20 |
| 1114022589 | Goslin Drug Store Inc | Pharmacy | 1212 13th Ave, Mendota, IL 61342 | 2006-09-13 |
| 1467402412 | Neungja Chung | Acupuncturist | Mendota Community Hospital, 1315 Memorial Drive, Mendota, IL 61342 | 2006-05-11 |
| 1487622205 | Kelly R. Minihane | Physician Assistant | 1404 Washington Street, Mendota, IL 61342 | 2006-03-08 |
| 1134193022 | Donald Wilbert Piller | Chiropractor | 1312 Lakewood Dr, Mendota, IL 61342 | 2006-02-15 |
| 1770975377 | National Pain Clinic, LLC | Anesthesiology | 1401 E 12th St, Mendota, IL 61342 | 2015-02-19 |
| 1073869475 | Katherine Rose Riva-foster | Anesthesiology | 1401 E 12th St, Mendota, IL 61342 | 2012-08-03 |
| 1386789220 | Juli Renee Barrett Leifheit | Chiropractor | 901 Main St, Ste A, Mendota, IL 61342 | 2007-02-20 |
| 1205383197 | Mendota Community Hospital | Clinic/Center | 1401 Washington Street, Mendota, IL 61342-0001 | 2016-09-08 |
| 1780699447 | Linnea L Person | Chiropractor | 1301 14th Ave, Mendota, IL 61342-1001 | 2006-07-30 |
| Find all providers in zip 61342 | ||||
| Taxonomy Code | 332BX2000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Oxygen Equipment & Supplies |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538113535 | Pekin Prohealth Inc. | Durable Medical Equipment & Medical Supplies | 710 Illinois Ave, Mendota, IL 61342-1638 | 2006-05-22 |
| 1871583906 | Heritage Manor Mendota, LLC | Durable Medical Equipment & Medical Supplies | 1201 1st Ave, Mendota, IL 61342-1815 | 2005-10-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821699026 | First Choice Medical Equipment, Inc | Durable Medical Equipment & Medical Supplies | 65 S 65th St Ste 10, Belleville, IL 62223-2946 | 2020-11-04 |
| 1619596624 | Gz Service Inc | Durable Medical Equipment & Medical Supplies | 576 Jennifer Cir, Mundelein, IL 60060-4110 | 2020-04-09 |
| 1528690526 | Nationwide Medical, Inc. | Durable Medical Equipment & Medical Supplies | 415 W Golf Rd Ste 48, Arlington Heights, IL 60005-3923 | 2020-02-07 |
| 1477024347 | Karma7 Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 1840 Industrial Dr Ste 160, Libertyville, IL 60048-9400 | 2018-12-17 |
| 1700354354 | True Respiratory Care & Medical Management LLC | Durable Medical Equipment & Medical Supplies | 11415 183rd Pl Ste B, Orland Park, IL 60467-5011 | 2018-11-12 |
| 1467951699 | Sarah Bush Lincoln Health Center | Durable Medical Equipment & Medical Supplies | 903 N Maple St, Effingham, IL 62401 | 2018-02-02 |
| 1215436449 | Sarah Bush Lincoln Health Center | Durable Medical Equipment & Medical Supplies | 300 Coles Centre Pkwy, Mattoon, IL 61938 | 2018-02-02 |
| 1669992665 | Easy Oxygen Inc. | Durable Medical Equipment & Medical Supplies | 1862 E Belvidere Road #125, Grayslake, IL 60030 | 2017-06-21 |
| 1487103560 | The Elms | Durable Medical Equipment & Medical Supplies | 1212 Madelyn Ave, Macomb, IL 61455-3324 | 2016-09-29 |
| 1457807257 | Genventures Inc | Durable Medical Equipment & Medical Supplies | 101 S. College Avenue, Aledo, IL 61231-1630 | 2016-08-31 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.