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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