| NPI | 1982948683 |
|---|---|
| Doing Business As | HERITAGE HEALTH - MENDOTA |
| Entity Type | Organization |
| Authorized Contact | DAVID M UNDERWOOD Sr. VP, CFO 309-823-7135 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies |
| Enumeration Date | 2012-11-19 |
| Last Update Date | 2014-04-24 |