Provider Demographics
NPI:1720080690
Name:VISITING NURSE & HOSPICE OF FAIRFIELD COUNTY, INC.
Entity Type:Organization
Organization Name:VISITING NURSE & HOSPICE OF FAIRFIELD COUNTY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-762-8958
Mailing Address - Street 1:PO BOX 489
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:CT
Mailing Address - Zip Code:06897
Mailing Address - Country:US
Mailing Address - Phone:203-762-8958
Mailing Address - Fax:203-761-8889
Practice Address - Street 1:22 DANBURY ROAD
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:CT
Practice Address - Zip Code:06897
Practice Address - Country:US
Practice Address - Phone:203-762-8958
Practice Address - Fax:203-761-8889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-11
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTC81891251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004042982Medicaid
CT077074Medicare Oscar/Certification
CT1720080690Medicare NSC