1104937697 NPI number — SOUTHCOAST VISITING NURSE ASSOCIATION. INC

Table of content: (NPI 1104937697)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104937697 NPI number — SOUTHCOAST VISITING NURSE ASSOCIATION. INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOUTHCOAST VISITING NURSE ASSOCIATION. INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1104937697
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/17/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 MILL ROAD, SUITE 120
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FAIRHAVEN
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02719
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-973-3210
Provider Business Mailing Address Fax Number:
508-973-3215

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 MILL ROAD, SUITE 120
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FAIRHAVEN
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02719
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-973-3210
Provider Business Practice Location Address Fax Number:
508-973-3215
Provider Enumeration Date:
08/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BUIOCCHI
Authorized Official First Name:
PATRICIA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT/CEO
Authorized Official Telephone Number:
508-973-3200

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  2211 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0007826 . This is a "NEIGHBORHOOD HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: VN01327 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 800878 . This is a "TUFT'S" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0603082 . This is a "BRISTOL ELDER SERVICES" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 201491 . This is a "BLUE CHIP" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 60-00162 . This is a "UNITED HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 800878 . This is a "TUFT'S" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 700288 . This is a "PILGRIM HEALTH CARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 60-00162 . This is a "UNITED HEALTH" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 001212 . This is a "SENIOR WHOLE HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: VN23910 . This is a "RI DPT HUMAN SERVICE" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 000000021838 . This is a "BMC HEALTHNET PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0469887 . This is a "US HEALTHCARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0603082 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5813-1 . This is a "RI BLUE CROSS" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 120-101 . This is a "HMO BLUE-BC/BS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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