Provider Demographics
NPI:1104805084
Name:HUNT COUNTRY NURSING SERVICE INC
Entity type:Organization
Organization Name:HUNT COUNTRY NURSING SERVICE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHICH
Authorized Official - Middle Name:A
Authorized Official - Last Name:GILPIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-347-4901
Mailing Address - Street 1:25 WINCHESTER ST
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-2825
Mailing Address - Country:US
Mailing Address - Phone:540-347-3919
Mailing Address - Fax:540-347-3720
Practice Address - Street 1:25 WINCHESTER ST
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-2825
Practice Address - Country:US
Practice Address - Phone:540-347-3919
Practice Address - Fax:540-347-3720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-10
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA251E00000X
332B00000X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251E00000XAgenciesHome Health
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA009104771Medicaid
VA4972708Medicaid
VA008750122Medicaid
VA497281AMedicare Oscar/Certification
VA009104771Medicaid