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General NPI Number Information
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NPI Number | 1720081912
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Entity Type | Organization
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Legal Business Name | MARTHAS VINEYARD COMMUNITY SERVICES, INC DBA VISITING NURSE SERVICE
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Dates
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Enumeration Date | 05/23/2005
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Last Update Date | 03/05/2014
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Provider Practice Location Address
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Address Line | 111 EDGARTOWN VINEYARD HAVEN ROAD
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City | OAK BLUFFS
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State | MA
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Zip | 02557
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Country | US
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Telephone | 508-693-7900
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Fax | 508-693-6669
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Provider Business Mailing Address
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Address Line | 111 EDGARTOWN RD
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City | VINEYARD HAVEN
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State | MA
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Zip | 02568-5601
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Country | US
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Telephone | 508-693-7900
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Fax | 508-693-6669
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Authorized Official
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Title or Position | CEO
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Name | MS. JULIA BURGESS
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Credential |
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Telephone | 508-693-7900
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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 | 005601
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License Number State | MA
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