Provider Demographics
NPI:1457896029
Name:VNA EXTENDED HOME CARE
Entity Type:Organization
Organization Name:VNA EXTENDED HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARION
Authorized Official - Middle Name:NUGENT
Authorized Official - Last Name:COWAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-463-6340
Mailing Address - Street 1:850 HOSPITAL RD STE 3000
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-3665
Mailing Address - Country:US
Mailing Address - Phone:724-463-1102
Mailing Address - Fax:724-463-1744
Practice Address - Street 1:850 HOSPITAL RD STE 3000
Practice Address - Street 2:
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-3665
Practice Address - Country:US
Practice Address - Phone:724-463-1102
Practice Address - Fax:724-463-1744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-05
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA11683601253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care