Provider Demographics
NPI:1154325561
Name:VISITING NURSE ASSOCIATION HOSPICE CARE
Entity Type:Organization
Organization Name:VISITING NURSE ASSOCIATION HOSPICE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-918-7171
Mailing Address - Street 1:9450 MANCHESTER RD
Mailing Address - Street 2:STE 206
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63119-1452
Mailing Address - Country:US
Mailing Address - Phone:314-918-7171
Mailing Address - Fax:314-918-7171
Practice Address - Street 1:9450 MANCHESTER RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63119-1452
Practice Address - Country:US
Practice Address - Phone:314-918-7171
Practice Address - Fax:314-918-7171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0288HO251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO261505Medicare ID - Type Unspecified