Provider Demographics
NPI:1679173520
Name:HERITAGE BIOLOGICS, LLC
Entity type:Organization
Organization Name:HERITAGE BIOLOGICS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SR. DIRECTOR OF QUALITY
Authorized Official - Prefix:
Authorized Official - First Name:BRIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:KALEIKAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-875-5256
Mailing Address - Street 1:255 NW VICTORIA DR, STE B
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64086-4709
Mailing Address - Country:US
Mailing Address - Phone:855-937-7273
Mailing Address - Fax:
Practice Address - Street 1:6313 PRESTON RD STE 200
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-2684
Practice Address - Country:US
Practice Address - Phone:855-937-7273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-29
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No251F00000XAgenciesHome Infusion
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No333600000XSuppliersPharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX33954OtherSTATE PERMIT
PA10324159Medicaid
OK200661640CMedicaid
AR297829407Medicaid
TX1679173520Medicaid