1043398498 NPI number — NORWELL VISITING NURSE ASSOCIATION INC

Table of content: (NPI 1043398498)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043398498 NPI number — NORWELL VISITING NURSE ASSOCIATION INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORWELL VISITING NURSE ASSOCIATION 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:
1043398498
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/20/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
120 LONGWATER DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORWELL
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02061
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
781-659-2342
Provider Business Mailing Address Fax Number:
781-659-0150

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
120 LONGWATER DR STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORWELL
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02061-1653
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-659-2342
Provider Business Practice Location Address Fax Number:
781-659-0150
Provider Enumeration Date:
11/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MCINNES
Authorized Official First Name:
RENEE
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
781-610-1435

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0007818 . This is a "NEIGHBORHOOD HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 7200033 . This is a "EVERCARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 800879 . This is a "TUFTS HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 19907 . This is a "FALLON COMMUNITY HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0604097 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 120241 . This is a "BLUE CROSS BLUE SHIELD MA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 700524 . This is a "HARVARD PILGRIM HEALTH CA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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