1528092343 NPI number — VISITING NURSE ASSOCIATION OF PORTER COUNTY, INDIANA, INC.

Table of content: (NPI 1528092343)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528092343 NPI number — VISITING NURSE ASSOCIATION OF PORTER COUNTY, INDIANA, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VISITING NURSE ASSOCIATION OF PORTER COUNTY, INDIANA, 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:
VNA HOSPICE HOMECARE
Provider Other Organization Name Type Code:
3
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:
1528092343
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/17/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
501 MARQUETTE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VALPARAISO
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46383-2508
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
219-462-5195
Provider Business Mailing Address Fax Number:
219-462-6020

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
501 MARQUETTE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VALPARAISO
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46383
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
219-462-5195
Provider Business Practice Location Address Fax Number:
219-462-6020
Provider Enumeration Date:
07/10/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FRANKO
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
J
Authorized Official Title or Position:
CEO/PRESIDENT
Authorized Official Telephone Number:
219-531-8053

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X , with the licence number:  06-005122-1 , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 9569 . This is a "BLUE CROSS OF ILLINOIS" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 200143110 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0000000189883 . This is a "ANTHEM" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".