Provider Demographics
NPI:1407020225
Name:VISITING NURSE ASSOCIATION MOBILE CLINIC INC
Entity Type:Organization
Organization Name:VISITING NURSE ASSOCIATION MOBILE CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:R
Authorized Official - Last Name:CROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-286-1844
Mailing Address - Street 1:2400 SE MONTEREY RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34996-3351
Mailing Address - Country:US
Mailing Address - Phone:772-286-1844
Mailing Address - Fax:772-286-0738
Practice Address - Street 1:2400 SE MONTEREY RD
Practice Address - Street 2:SUITE 300
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34996-3351
Practice Address - Country:US
Practice Address - Phone:772-286-1844
Practice Address - Fax:772-286-0738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-14
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care