Healthcare Provider Details

I. General information

NPI: 1528045887
Provider Name (Legal Business Name): SLATE BELT VISITING NURSES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2005
Last Update Date: 12/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

269 BLUE VALLEY DR
BANGOR PA
18013-1512
US

IV. Provider business mailing address

PO BOX 215
PEN ARGYL PA
18072-0215
US

V. Phone/Fax

Practice location:
  • Phone: 610-863-7281
  • Fax: 610-863-6317
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number749805
License Number StatePA

VIII. Authorized Official

Name: MRS. MARION HALL
Title or Position: CLINICAL ADMINISTRATOR
Credential: R.N.
Phone: 610-863-7281