Provider Demographics
NPI:1629733753
Name:HOSPICE OF MARTHA'S VINEYARD, INC.
Entity Type:Organization
Organization Name:HOSPICE OF MARTHA'S VINEYARD, INC.
Other - Org Name:HOSPICE AND PALLIATIVE CARE OF MARTHA'S VINEYARD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:S
Authorized Official - Last Name:WOZNIAK
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, MPH
Authorized Official - Phone:508-693-0189
Mailing Address - Street 1:PO BOX 1748
Mailing Address - Street 2:
Mailing Address - City:VINEYARD HAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02568-0910
Mailing Address - Country:US
Mailing Address - Phone:508-693-0189
Mailing Address - Fax:508-693-0277
Practice Address - Street 1:79 BEACH RD
Practice Address - Street 2:
Practice Address - City:VINEYARD HAVEN
Practice Address - State:MA
Practice Address - Zip Code:02568-2600
Practice Address - Country:US
Practice Address - Phone:508-693-0189
Practice Address - Fax:508-693-0277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-03
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based