Provider Demographics
NPI:1720197619
Name:VERNON HOME HEALTH INC
Entity Type:Organization
Organization Name:VERNON HOME HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:LOU
Authorized Official - Last Name:BLACKSHER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:318-561-8262
Mailing Address - Street 1:PO BOX 12247
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71315-2247
Mailing Address - Country:US
Mailing Address - Phone:318-561-8262
Mailing Address - Fax:318-484-3858
Practice Address - Street 1:213 ALEXANDRIA HWY
Practice Address - Street 2:
Practice Address - City:LEESVILLE
Practice Address - State:LA
Practice Address - Zip Code:71446
Practice Address - Country:US
Practice Address - Phone:337-238-0506
Practice Address - Fax:337-238-1528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA197413Medicare Oscar/Certification