Provider Demographics
NPI:1831277227
Name:HOSPICE-VNSW WPHC, INC.
Entity type:Organization
Organization Name:HOSPICE-VNSW WPHC, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:COLBURN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-682-1484
Mailing Address - Street 1:311 NORTH ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-2217
Mailing Address - Country:US
Mailing Address - Phone:914-682-1484
Mailing Address - Fax:914-559-3092
Practice Address - Street 1:311 NORTH ST
Practice Address - Street 2:SUITE 204
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-2217
Practice Address - Country:US
Practice Address - Phone:914-682-1484
Practice Address - Fax:914-559-3092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5902501F251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01353960Medicaid
NY01353960Medicaid