Basic Information
| Provider Information | |||||||||
| NPI: | 1376890574 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HOME NURSING AGENCY & VISITING NURSE ASSOCIATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | 201 CHESTNUT AVE | ||||||||
| Address2: | HOME HEALTH - NW | ||||||||
| City: | ALTOONA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 166014927 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8149465411 | ||||||||
| FaxNumber: | 8149408471 | ||||||||
| Practice Location | |||||||||
| Address1: | 320 FRANKLIN STREET | ||||||||
| Address2: | HOME HEALTH - NW | ||||||||
| City: | CLYMER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 157281181 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7242543500 | ||||||||
| FaxNumber: | 7242543503 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/07/2012 | ||||||||
| LastUpdateDate: | 04/24/2015 | ||||||||
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| AuthorizedOfficialLastName: | FREEMAN | ||||||||
| AuthorizedOfficialFirstName: | PHILIP | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8149465411 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNameSuffix: | JR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | Y | Agencies | Home Health |
No ID Information.