1508946948 NPI number — VISITING NURSE ASSOCIATION AND HOME HEALTH MAINTENANCE ORGANIZATION

Table of content: (NPI 1508946948)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508946948 NPI number — VISITING NURSE ASSOCIATION AND HOME HEALTH MAINTENANCE ORGANIZATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VISITING NURSE ASSOCIATION AND HOME HEALTH MAINTENANCE ORGANIZATION
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:
1508946948
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/20/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
301 DELAWARE AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OLYPHANT
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18447-1531
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
301 DELAWARE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OLYPHANT
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18447-1531
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-383-5180
Provider Business Practice Location Address Fax Number:
570-383-5189
Provider Enumeration Date:
10/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GRATTOLINO
Authorized Official First Name:
MARLENE
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
570-383-5180

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X , with the licence number:  154399 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 73 . This is a "HOME HEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 808351 . This is a "HOMEHEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 808351 . This is a "HOSPICE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1007786300006 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1007786300002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9J . This is a "HOSPICE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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