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Organization

PLYMOUTH VISITING NURSE ASSOCIATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JUDITH BLANCHET R.N. (ADMINISTRATIVE SUPERVISOR)
(860) 585-4026
Entity
Organization

Contact information

Practice address
244 MAIN ST, TERRYVILLE, CT 06786-5901
(860) 585-4026
(860) 585-4063
Mailing address
244 MAIN ST, TERRYVILLE, CT 06786-5901
(860) 585-4026
(860) 585-4063

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
C81911
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
004PPHA103
CCCI
CT
01
4040027
STATE FUNDED ELDERLY PROG
CT
05
4043154
CT
01
685 ZG
ANTHEM BC BS OF CT
CT
01
68VNA0074CT01
ANTHEM BC BS OF CT
CT
Enumeration date
08/31/2006
Last updated
08/22/2020
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