Provider Demographics
NPI:1922831601
Name:HEART TO HOME MEDICAL SERVICES PLLC
Entity type:Organization
Organization Name:HEART TO HOME MEDICAL SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:D
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:502-216-2733
Mailing Address - Street 1:4505 ABBOTT GROVE PL
Mailing Address - Street 2:
Mailing Address - City:CRESTWOOD
Mailing Address - State:KY
Mailing Address - Zip Code:40014-8437
Mailing Address - Country:US
Mailing Address - Phone:502-216-2733
Mailing Address - Fax:
Practice Address - Street 1:4505 ABBOTT GROVE PL
Practice Address - Street 2:
Practice Address - City:CRESTWOOD
Practice Address - State:KY
Practice Address - Zip Code:40014-8437
Practice Address - Country:US
Practice Address - Phone:502-216-2733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-20
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty