Provider Demographics
NPI:1124168109
Name:VNA PRIVATECARE, INC.
Entity type:Organization
Organization Name:VNA PRIVATECARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANDARLIS
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:618-467-3559
Mailing Address - Street 1:200 N CENTER DR
Mailing Address - Street 2:
Mailing Address - City:ALTON
Mailing Address - State:IL
Mailing Address - Zip Code:62002-5946
Mailing Address - Country:US
Mailing Address - Phone:618-467-3559
Mailing Address - Fax:
Practice Address - Street 1:3445 BRIDGELAND DR
Practice Address - Street 2:STE 121
Practice Address - City:BRIDGETON
Practice Address - State:MO
Practice Address - Zip Code:63044-2621
Practice Address - Country:US
Practice Address - Phone:618-467-3559
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care