1063494698 NPI number — VISITING NURSE ASSOCIATION AND HOSPICE OF VT AND NH INC

Table of content: (NPI 1063494698)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063494698 NPI number — VISITING NURSE ASSOCIATION AND HOSPICE OF VT AND NH INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VISITING NURSE ASSOCIATION AND HOSPICE OF VT AND NH 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:
6
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:
1063494698
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/10/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
88 PROSPECT RD.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WHITE RIVER JUNCTION
Provider Business Mailing Address State Name:
VT
Provider Business Mailing Address Postal Code:
05001-5405
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-300-8853
Provider Business Mailing Address Fax Number:
603-298-3389

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
88 PROSPECT RD.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WHITE RIVER JUNCTION
Provider Business Practice Location Address State Name:
VT
Provider Business Practice Location Address Postal Code:
05001-5405
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-300-8853
Provider Business Practice Location Address Fax Number:
603-298-3389
Provider Enumeration Date:
11/18/2005

Additional Information

Authorized Official

Authorized Official Last Name:
BEST
Authorized Official First Name:
GERRY
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR, REVENUE CYCLE
Authorized Official Telephone Number:
888-300-8853

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X , with the licence number:  03103 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: 03103 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251G00000X , with the licence number: 03104 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251J00000X , with the licence number: 03103 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251K00000X , with the licence number: 03103 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1004967 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0471506 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1004590 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 047701 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 30004280 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3073407 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3076589 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1005277 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 30005169 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 477001 . This is a "BCBS HOSPICE" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".
  • Identifier: 477001 . This is a "BCBS HOSPICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 047W017 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3079798 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 477001 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 800577 . This is a "ANTHEM BCBS" identifier . This identifiers is of the category "OTHER".




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