MEDICARE: VNA-HOSPICE OF SOUTHERN CARROLL COUNTY & VICINITY,INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	01937	NH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508860875
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VNA-HOSPICE OF SOUTHERN CARROLL COUNTY & VICINITY,INC.

Provider Business Mailing Address
First Line	:	PO BOX 1620
Second Line	:
City	:	WOLFEBORO
State	:	NH
Zip	:	03894-1620
Country	:	US
Telephone Number	:	603-569-2729
Fax Number	:	603-569-2409

Provider Business Practice Location Address
First Line	:	240 S MAIN ST
Second Line	:
City	:	WOLFEBORO
State	:	NH
Zip	:	03894-4411
Country	:	US
Telephone Number	:	603-569-2729
Fax Number	:	603-569-2409

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	GEORGE LABAN
Credential	:
Telephone Number	:	603-569-2729

Provider Enumeration Date	:	06/02/2005
Last Update Date	:	02/11/2008

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Directions to “VNA-HOSPICE OF SOUTHERN CARROLL COUNTY & VICINITY,INC. ” Practice Location

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