Provider Demographics
NPI:1720083025
Name:VNA OF CORDELE, INC.
Entity Type:Organization
Organization Name:VNA OF CORDELE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:B
Authorized Official - Last Name:GUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-273-5545
Mailing Address - Street 1:511 E 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:CORDELE
Mailing Address - State:GA
Mailing Address - Zip Code:31015-3608
Mailing Address - Country:US
Mailing Address - Phone:229-273-5545
Mailing Address - Fax:229-273-7717
Practice Address - Street 1:511 E 3RD AVE
Practice Address - Street 2:
Practice Address - City:CORDELE
Practice Address - State:GA
Practice Address - Zip Code:31015-3608
Practice Address - Country:US
Practice Address - Phone:229-273-5545
Practice Address - Fax:229-273-7717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA8322920-HC251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA11-7071Medicare ID - Type UnspecifiedHOME HEALTH