Basic Information
| Provider Information | |||||||||
| NPI: | 1346325743 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | VNA HOME HEALTH SERVICES | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
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| OtherOrganizationName: | WELLSPAN VNA HOME CARE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
| OtherLastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 785 5TH AVE STE 3 | ||||||||
| Address2: | |||||||||
| City: | CHAMBERSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 172014232 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172639555 | ||||||||
| FaxNumber: | 7177096529 | ||||||||
| Practice Location | |||||||||
| Address1: | 1503 QUENTIN RD | ||||||||
| Address2: | |||||||||
| City: | LEBANON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170427431 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172742591 | ||||||||
| FaxNumber: | 7172743923 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/25/2006 | ||||||||
| LastUpdateDate: | 11/01/2021 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | BUCZKOWSKI | ||||||||
| AuthorizedOfficialFirstName: | LAURA | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | SR VP AND CFO | ||||||||
| AuthorizedOfficialTelephone: | 4102590783 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | WELLSPAN HEALTH | ||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 11/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | 702605 | PA | Y | Agencies | Home Health |
ID Information
| ID | Type | State | Issuer | Description | 000000151408 | 01 | PA | UNISON MEDPLUS | OTHER | 33781 | 01 | PA | HEALTH AMERICA | OTHER | 1018197 | 01 | PA | KEYSTONE MERCY | OTHER | 397026B | 01 | GEISINGER GOLD | OTHER | 1521439 | 01 | GATEWAY MEDICARE ASSURED | OTHER | 397026B | 01 | HUMANA GOLD | OTHER | 1007732780053 | 05 | PA | MEDICAID | 100778621 | 05 | PA | MEDICAID | 397026 | 01 | PA | CAPITAL BLUE CROSS | OTHER | 397026B | 01 | STERLING OPTION 1 | OTHER | 1521439 | 01 | PA | GATEWAY HEALTH PLAN | OTHER | 1561 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 60685 | 01 | PA | AMERIHEALTH MERCY | OTHER | 7510 | 01 | PA | AETNA | OTHER | 08274 | 01 | PA | HEALTH PARTNERS | OTHER | 116415000 | 01 | PA | FEDERAL WORK COMP | OTHER | 397026 | 01 | PA | KEYSTONE HEALTH PLAN CENT | OTHER | 397026B | 01 | ADVANTRA | OTHER |