Provider Demographics
NPI:1285816306
Name:VNA HOMECARE, INC.
Entity Type:Organization
Organization Name:VNA HOMECARE, INC.
Other - Org Name:VNA-TIP HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUZY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANDARLIS
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:1618-467-2080
Mailing Address - Street 1:200 N CENTER DR
Mailing Address - Street 2:
Mailing Address - City:ALTON
Mailing Address - State:IL
Mailing Address - Zip Code:62002-5946
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 N CENTER DR
Practice Address - Street 2:
Practice Address - City:ALTON
Practice Address - State:IL
Practice Address - Zip Code:62002-5946
Practice Address - Country:US
Practice Address - Phone:618-467-2080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-30
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL14260Medicare PIN