Provider Demographics
NPI:1023207693
Name:VISITING NURSE SERVICE INC
Entity Type:Organization
Organization Name:VISITING NURSE SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEIF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PUSKARICH
Authorized Official - Suffix:
Authorized Official - Credentials:CFO
Authorized Official - Phone:317-722-8299
Mailing Address - Street 1:4701 N KEYSTONE AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46205-1554
Mailing Address - Country:US
Mailing Address - Phone:317-722-8200
Mailing Address - Fax:317-722-8219
Practice Address - Street 1:4701 N KEYSTONE AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46205-1554
Practice Address - Country:US
Practice Address - Phone:317-722-8200
Practice Address - Fax:317-722-8219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-19
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN157008Medicare PIN