1790758928 NPI number — CLARION FOREST VNA, INC

Table of content: (NPI 1790758928)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790758928 NPI number — CLARION FOREST VNA, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CLARION FOREST 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:
1790758928
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
271 PERKINS RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLARION
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16214-8535
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-297-8400
Provider Business Mailing Address Fax Number:
814-297-8801

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
271 PERKINS RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLARION
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16214-8535
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-297-8400
Provider Business Practice Location Address Fax Number:
814-297-8801
Provider Enumeration Date:
02/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
VICKERS
Authorized Official First Name:
COLETTE
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
814-297-8400

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  711605 , 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: 000000095541 . This is a "THREE RIVERS MED" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 103977 . This is a "UPMC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 079219800 . This is a "BLACK LUNG" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0010815400001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 332758 . This is a "ADVANTRA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0754 . This is a "BLUE CROSS VNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2402 . This is a "HEALTH AMER/HEALTH ASSURA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 5556135 . This is a "AETNA COMMERCIAL" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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