Healthcare Provider Details

I. General information

NPI: 1982687943
Provider Name (Legal Business Name): MIDSTATE VNA & HOSPICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 RESEARCH PKWY
MERIDEN CT
06450-8400
US

IV. Provider business mailing address

1 RESEARCH PKWY
MERIDEN CT
06450-8400
US

V. Phone/Fax

Practice location:
  • Phone: 203-235-5714
  • Fax:
Mailing address:
  • Phone: 203-235-5714
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberC81751
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License NumberC81751
License Number StateCT

VIII. Authorized Official

Name: SUSAN WILSON
Title or Position: PRESIDENT/CEO
Credential: RN, MPH, CHCE
Phone: 203-235-5714