1982687943 NPI number — MIDSTATE VNA & HOSPICE

Table of content: (NPI 1982687943)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982687943 NPI number — MIDSTATE VNA & HOSPICE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MIDSTATE VNA & HOSPICE
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:
1982687943
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 RESEARCH PKWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MERIDEN
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06450-8400
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-235-5714
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 RESEARCH PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MERIDEN
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06450-8400
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-235-5714
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/23/2005

Additional Information

Authorized Official

Authorized Official Last Name:
WILSON
Authorized Official First Name:
SUSAN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT/CEO
Authorized Official Telephone Number:
203-235-5714

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  C81751 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 251G00000X , with the licence number: C81751 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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

  • Identifier: 185412 . This is a "FIRST CHOICE HEALTH PLAN" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 0782132 . This is a "AETNA" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: C81751 . This is a "CIGNA" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 747022 . This is a "CONNECTICARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 677HH . This is a "ABCBS" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: A789028 . This is a "OXFORD HEALTH PLAN" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




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