1497731467 NPI number — GREATER LEHIGH VALLEY VISITING NURSE ASSOCIATION, INC.

Table of content: (NPI 1497731467)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497731467 NPI number — GREATER LEHIGH VALLEY VISITING NURSE ASSOCIATION, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GREATER LEHIGH VALLEY 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:
1497731467
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/25/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1170 BERKSHIRE BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WYOMISSING
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19610-1215
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-378-0481
Provider Business Mailing Address Fax Number:
610-378-9762

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
501 N 17TH ST
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18104-5044
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-395-2500
Provider Business Practice Location Address Fax Number:
610-432-1675
Provider Enumeration Date:
12/21/2005

Additional Information

Authorized Official

Authorized Official Last Name:
GOUGH
Authorized Official First Name:
LUCILLE
Authorized Official Middle Name:
D
Authorized Official Title or Position:
PRESIDENT/CEO
Authorized Official Telephone Number:
610-378-0481

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  758405 , 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: 1009922 . This is a "KEYSTONE MERCY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 397584 . This is a "CBC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 521032 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0000822000 . This is a "IBC MOTHER OPTIONS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0000824000 . This is a "IBC BABY BLUE PRINT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1686 . This is a "HIGHMARK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0000821000 . This is a "IBC PRIVATE DUTY NURSING" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0017455980001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1009922 . This is a "AMERIHEALTH MERCY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1138 . This is a "GENTIVA CARE CENTRIX" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0000820000 . This is a "IBC" identifier . This identifiers is of the category "OTHER".




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