1922093194 NPI number — HOLYOKE VISITING NURSE ASSOCIATION, INC.

Table of content: (NPI 1922093194)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922093194 NPI number — HOLYOKE VISITING NURSE ASSOCIATION, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOLYOKE 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:
1922093194
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/09/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
575 BEECH STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOLYOKE
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01040-2223
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
413-533-3923
Provider Business Mailing Address Fax Number:
413-536-4513

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10 HOSPITAL DRIVE
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
HOLYOKE
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01040-6603
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-533-3923
Provider Business Practice Location Address Fax Number:
413-552-0311
Provider Enumeration Date:
09/14/2005

Additional Information

Authorized Official

Authorized Official Last Name:
BOSS
Authorized Official First Name:
PAULA
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
413-534-5691

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0604976 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 221526 . This is a "BLUE SHIELD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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