Provider Demographics
NPI:1063483501
Name:VISITING NURSE ASSOCIATION OF SAINT CLARE'S, INC.
Entity Type:Organization
Organization Name:VISITING NURSE ASSOCIATION OF SAINT CLARE'S, INC.
Other - Org Name:VISITING NURSE ASSOCIATION OF SUSSEX COUNTY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ORGANIZATIONAL CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:FRED
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-729-7078
Mailing Address - Street 1:191 WOODPORT RD
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-2641
Mailing Address - Country:US
Mailing Address - Phone:973-729-7078
Mailing Address - Fax:973-729-7057
Practice Address - Street 1:191 WOODPORT RD
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871-2641
Practice Address - Country:US
Practice Address - Phone:973-729-7078
Practice Address - Fax:973-729-7057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-01
Last Update Date:2009-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ71902251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
242176OtherLIBERTY MUTUAL
33550OtherAMERI-GROUP
OLO538OtherHEALTH NET
011086OtherAETNA
1033739OtherHORIZON NJ HEALTH
120635OtherGHI
317076OtherBCBS OF NEW JERSEY
35182OtherCORE SOURCE
A437744COtherOXFORD
139989OtherGENTIVA
4222OtherAMERIHEALTH
NJ3692400Medicaid
3692418OtherPCA/CCPED
78010000317076OtherFEDERAL HORIZON
33550OtherAMERI-GROUP