1609877117 NPI number — HOME HEALTH VNA INC

Table of content: (NPI 1609877117)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609877117 NPI number — HOME HEALTH VNA INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOME HEALTH VNA 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:
1609877117
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
360 MERRIMACK ST
Provider Second Line Business Mailing Address:
BUILDING 9
Provider Business Mailing Address City Name:
LAWRENCE
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01843-1740
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-552-4000
Provider Business Mailing Address Fax Number:
978-552-4410

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
360 MERRIMACK ST
Provider Second Line Business Practice Location Address:
BUILDING 9
Provider Business Practice Location Address City Name:
LAWRENCE
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01843-1740
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-552-4000
Provider Business Practice Location Address Fax Number:
978-552-4410
Provider Enumeration Date:
08/09/2005

Additional Information

Authorized Official

Authorized Official Last Name:
GOMES
Authorized Official First Name:
KAREN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT/CFO
Authorized Official Telephone Number:
978-552-4000

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: 30001925 . This is a "NH MEDICAID" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 0603015 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 700840 . This is a "HARVARD PILGRIM HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 800914 . This is a "TUFTS ASSOCIATED HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 120206 . This is a "BLUE CROSS OF MA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 31343 . This is a "FALLON COMMUNITY" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 227206 . This is a "ANTHEM BLUE CROSS" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 30003584 . This is a "NH MEDICAID(HCBC)" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".




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