Provider Demographics
NPI:1013911650
Name:NORTH PENN VISITING NURSE ASSOCIATION
Entity Type:Organization
Organization Name:NORTH PENN VISITING NURSE ASSOCIATION
Other - Org Name:HOSPICE OF NORTH PENN VNA
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:FITZGERALD
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MBA
Authorized Official - Phone:215-855-8296
Mailing Address - Street 1:51 MEDICAL CAMPUS DR
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-1254
Mailing Address - Country:US
Mailing Address - Phone:215-855-8296
Mailing Address - Fax:215-855-1305
Practice Address - Street 1:51 MEDICAL CAMPUS DR
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-1254
Practice Address - Country:US
Practice Address - Phone:215-855-8296
Practice Address - Fax:215-855-1305
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTH PENN VISITING NURSE ASSOCIATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-06-10
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA152899251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0001640000OtherINDEPENDENCE BLUE CROSS
PA31321OtherAETNA
PA01145773Medicaid
PA01145773Medicaid