Provider Demographics
NPI:1437139664
Name:VISITING NURSE ASSOCIATION AND HOSPICE OF WESTERN NEW ENGLAND, INC.
Entity Type:Organization
Organization Name:VISITING NURSE ASSOCIATION AND HOSPICE OF WESTERN NEW ENGLAND, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:DEGEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-795-0215
Mailing Address - Street 1:30 CAPITAL DR STE A
Mailing Address - Street 2:
Mailing Address - City:WEST SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089-1359
Mailing Address - Country:US
Mailing Address - Phone:413-794-6411
Mailing Address - Fax:413-794-6476
Practice Address - Street 1:30 CAPITAL DR STE A
Practice Address - Street 2:
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-1359
Practice Address - Country:US
Practice Address - Phone:413-794-6411
Practice Address - Fax:413-794-6476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-23
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7219251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA17494OtherHEALTH NEW ENGLAND
MA6000021OtherUNITED HEALTHCARE
MA0605140Medicaid
MA805737OtherTUFTS HEALTH PLAN
MA000000005549OtherHEALTHNET
MA221521OtherBCBS
MA6000021OtherUNITED HEALTHCARE
MA=========OtherCIGNA
MA0605140Medicaid
MA221521OtherBCBS
MA=========OtherGIC
MA=========OtherUNICARE
MA17494OtherHEALTH NEW ENGLAND
MA=========OtherLONDON HEALTH/NORTHEAST D
MA=========OtherCONSOLIDATED HEALTH PLAN
MA221521AMedicare ID - Type Unspecified