Provider Demographics
NPI:1770289720
Name:HOSPICE OF MARTHA'S VINEYARD, INC.
Entity type:Organization
Organization Name:HOSPICE OF MARTHA'S VINEYARD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:WOZNIAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-693-0189
Mailing Address - Street 1:PO BOX 1748
Mailing Address - Street 2:
Mailing Address - City:VINEYARD HAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02568-0910
Mailing Address - Country:US
Mailing Address - Phone:508-693-0189
Mailing Address - Fax:
Practice Address - Street 1:79 BEACH ROAD, SUITE 28
Practice Address - Street 2:VINEYARD HAVEN
Practice Address - City:VINEYARD HAVEN
Practice Address - State:MA
Practice Address - Zip Code:02568
Practice Address - Country:US
Practice Address - Phone:508-693-0189
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOSPICE OF MARTHA'S VINEYARD, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Single Specialty