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General NPI Number Information
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NPI Number | 1528168861
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Entity Type | Organization
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Legal Business Name | MIDSTATE VNA & HOSPICE INC
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 11/26/2007
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Provider Practice Location Address
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Address Line | 1 RESEARCH PKWY
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City | MERIDEN
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State | CT
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Zip | 06450-8400
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Country | US
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Telephone | 203-235-5714
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Fax | 203-630-9841
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Provider Business Mailing Address
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Address Line | 1 RESEARCH PKWY
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City | MERIDEN
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State | CT
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Zip | 06450-8400
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Country | US
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Telephone | 203-235-5714
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Fax | 203-630-9841
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MS. ELLEN ROTHBERG
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Credential | RN, MPH
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Telephone | 203-235-5714
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | C81751
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License Number State | CT
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