1407856800 NPI number — VNA & HOSPICE OF THE SOUTHWEST REGION, INC

Table of content: (NPI 1407856800)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407856800 NPI number — VNA & HOSPICE OF THE SOUTHWEST REGION, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VNA & HOSPICE OF THE SOUTHWEST REGION, 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:
1407856800
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/11/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7 ALBERT CREE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RUTLAND
Provider Business Mailing Address State Name:
VT
Provider Business Mailing Address Postal Code:
05701-4601
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
802-775-0568
Provider Business Mailing Address Fax Number:
802-775-2304

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7 ALBERT CREE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RUTLAND
Provider Business Practice Location Address State Name:
VT
Provider Business Practice Location Address Postal Code:
05701-4601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
802-775-0568
Provider Business Practice Location Address Fax Number:
802-775-2304
Provider Enumeration Date:
07/28/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CIOFFI
Authorized Official First Name:
RONALD
Authorized Official Middle Name:
J
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
802-770-1544

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X , with the licence number:  477007 , registered in the state of VT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: 477007 , registered in the state of VT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251J00000X , with the licence number: 477007 , registered in the state of VT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251K00000X , with the licence number: 477007 , registered in the state of VT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 1005137 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1004949 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 047W198 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0477007 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".