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Organization
VISITING NURSE ASSOCIATION AND HOME HEALTH MAINTENANCE ORGANIZATION
Active
Organization
VISITING NURSE ASSOCIATION AND HOME HEALTH MAINTENANCE ORGANIZATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL TOLERICO (CONTROLLER)
(570) 383-5180
Entity
Organization
Contact information
Practice address
301 DELAWARE AVE, OLYPHANT, PA 18447-1531
(570) 383-5180
(570) 383-5189
Mailing address
301 DELAWARE AVE, OLYPHANT, PA 18447-1531
(570) 383-5180
(570) 383-5189
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
705005
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
078752
HOME HEALTH
PA
05
—
1007786300002
—
PA
05
—
1007786300006
—
PA
01
—
73
HOME HEALTH
PA
01
—
808351
HOSPICE
PA
01
—
9J
HOSPICE
PA
Enumeration date
09/25/2006
Last updated
06/17/2020
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