Provider Demographics
NPI:1194963793
Name:ASPIRUS VNA EXTENDED CARE, INC
Entity type:Organization
Organization Name:ASPIRUS VNA EXTENDED CARE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP OF POST ACUTE CARE
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:DONNELLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-847-2969
Mailing Address - Street 1:PO BOX 955
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54402-0955
Mailing Address - Country:US
Mailing Address - Phone:715-847-2000
Mailing Address - Fax:715-847-2315
Practice Address - Street 1:520 N 32ND AVE
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-4701
Practice Address - Country:US
Practice Address - Phone:715-847-2600
Practice Address - Fax:715-847-2315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-04
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1194963793Medicaid