Provider Demographics
NPI:1750529145
Name:VITACARE HOSPICE INC
Entity type:Organization
Organization Name:VITACARE HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:POLTAVSKIY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-953-9225
Mailing Address - Street 1:255 E STREET RD
Mailing Address - Street 2:
Mailing Address - City:FEASTERVILLE TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-6157
Mailing Address - Country:US
Mailing Address - Phone:215-953-9225
Mailing Address - Fax:215-953-9301
Practice Address - Street 1:255 E STREET RD
Practice Address - Street 2:
Practice Address - City:FEASTERVILLE TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-6157
Practice Address - Country:US
Practice Address - Phone:215-953-9225
Practice Address - Fax:215-953-9301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-23
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based