1174525380 NPI number — VISITING NURSE ASSOCIATION OF THE INLAND COUNTIES

Table of content: (NPI 1659484368)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174525380 NPI number — VISITING NURSE ASSOCIATION OF THE INLAND COUNTIES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VISITING NURSE ASSOCIATION OF THE INLAND COUNTIES
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:
VNA OF THE INLAND COUNTIES
Provider Other Organization Name Type Code:
5
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:
1174525380
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/29/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6235 RIVER CREST DR
Provider Second Line Business Mailing Address:
STE L
Provider Business Mailing Address City Name:
RIVERSIDE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92507-0758
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
951-413-1270
Provider Business Mailing Address Fax Number:
951-413-1208

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6235 RIVER CREST DR
Provider Second Line Business Practice Location Address:
STE L
Provider Business Practice Location Address City Name:
RIVERSIDE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92507-0758
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
951-413-1200
Provider Business Practice Location Address Fax Number:
951-413-1208
Provider Enumeration Date:
06/01/2005

Additional Information

Authorized Official

Authorized Official Last Name:
WALIA
Authorized Official First Name:
RAJNIT
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
951-413-1200

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  250000025 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 197679402 . This is a "ACS DEPT OF LABOR PROV #" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 197679403 . This is a "ACS DEPT OF LABOR PROV #" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 197679401 . This is a "ACS DEPT OF LABOR PROV #" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 197679404 . This is a "ACS DEPT OF LABOR PROV #" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 197679406 . This is a "ACS DEPT OF LABOR PROV #" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: ZZT07013F , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 197679405 . This is a "ACS DEPT OF LABOR PROV #" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: ZZZ34754Z . This is a "BLUE SHIELD PROVIDER # HH" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 197679400 . This is a "ACS DEPT. OF LABOR PROV #" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com