Provider Demographics
NPI:1417930181
Name:VISITING NURSE ASSOC. OF THE WABASH VALLEY,INC.
Entity Type:Organization
Organization Name:VISITING NURSE ASSOC. OF THE WABASH VALLEY,INC.
Other - Org Name:HOSPICE OF THE WABASH VALLEY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP & C.O.O.
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:RUPSKA
Authorized Official - Suffix:
Authorized Official - Credentials:RN,MS
Authorized Official - Phone:812-232-7611
Mailing Address - Street 1:400 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47804-4030
Mailing Address - Country:US
Mailing Address - Phone:812-232-7611
Mailing Address - Fax:812-232-1024
Practice Address - Street 1:400 8TH AVE
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47804-4030
Practice Address - Country:US
Practice Address - Phone:812-232-7611
Practice Address - Fax:812-232-1024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN251E00000X, 251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251E00000XAgenciesHome Health
Not Answered251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
151510Medicare ID - Type UnspecifiedHOSPICE
157015Medicare ID - Type UnspecifiedTRADITIONAL HOME CARE