Provider Demographics
NPI:1558444638
Name:THE GREATER BRISTOL VISITING NURSE ASSOCIATION INC
Entity Type:Organization
Organization Name:THE GREATER BRISTOL VISITING NURSE ASSOCIATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:DOLSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:860-583-1644
Mailing Address - Street 1:195 MALTAY STREET
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-3817
Mailing Address - Country:US
Mailing Address - Phone:860-583-1644
Mailing Address - Fax:860-314-2900
Practice Address - Street 1:195 MALTAY STREET
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-3817
Practice Address - Country:US
Practice Address - Phone:860-583-1644
Practice Address - Fax:860-314-2900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
C81E0000X251E00000X
C81641251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251E00000XAgenciesHome Health
Not Answered251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
66921OtherBLUE CROSS BLUE SHIELD
07159OtherMEDICARE HOSPICE
077042Medicare ID - Type Unspecified