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NPI Code Detail

MEDICARE: VISTACARE USA, LLC

MEDICARE: VISTACARE USA, LLC
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
1251G00000XCommunity Based Hospice Care Agency

Other Identifiers

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

General Provider Information

NPI Number : 1952319113
Entity Type Code : Organization
Provider Name (Legal Business Name) : VISTACARE USA, LLC
Provider Business Mailing Address
First Line : PO BOX 4060
Second Line :
City : MOORESVILLE
State : NC
Zip : 28117-4060
Country : US
Telephone Number : 704-664-2876
Fax Number : 704-664-1306
Provider Business Practice Location Address
First Line : 37 S PARK BLVD BLDG 1
Second Line :
City : GREENWOOD
State : IN
Zip : 46143-8838
Country : US
Telephone Number : 317-788-0300
Fax Number : 317-788-8748
Authorized Official
Title or Position : VP OF LICENSURE
Name : MS. JANET COMBS
Credential :
Telephone Number : 704-664-2876
Provider Enumeration Date : 08/04/2006
Last Update Date : 01/17/2023

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Directions to “VISTACARE USA, LLC ” Practice Location

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