1801990452 NPI number — SOUTHCOAST VISITING NURSE ASSOCIATION, INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801990452 NPI number — SOUTHCOAST VISITING NURSE ASSOCIATION, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOUTHCOAST 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:
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:
1801990452
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/17/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 MILL ROAD, SUITE 120
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FAIRHAVEN
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02719
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-973-3210
Provider Business Mailing Address Fax Number:
508-973-3215

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 MILL ROAD, SUITE 120
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FAIRHAVEN
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02719
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-973-3210
Provider Business Practice Location Address Fax Number:
508-973-3215
Provider Enumeration Date:
09/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BUIOCCHI
Authorized Official First Name:
PATRICIA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT/CEO
Authorized Official Telephone Number:
508-973-3200

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X , with the licence number:  1612 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251G00000X , with the licence number: 7223 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000000021841 . This is a "BMC HEALTHNET" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 5813-1 . This is a "RI BLUE CROSS/BLUE SHIELD" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 805736 . This is a "TUFT'S HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0605492 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6001001 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0469887 . This is a "AETNA US HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 700288 . This is a "HARVARD PILGRIM HEALTH CA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: VN26573 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 003493 . This is a "SENIOR WHOLE HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 6001001 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 0605492 . This is a "BRISTOL ELDER SERVICES" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 221536 . This is a "BLUE CROSS/BLUE SHIELD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 700288 . This is a "HARVARD PILGRIM HEALTH CA" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 0469887 . This is a "AETNA US HEALTH" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 805736 . This is a "TUFT'S HEALTH PLAN" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".




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