Provider Demographics
NPI:1366524688
Name:DEACONESS VNA PLUS, LLC
Entity type:Organization
Organization Name:DEACONESS VNA PLUS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:HORTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-425-3561
Mailing Address - Street 1:PO BOX 3487
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47734-3487
Mailing Address - Country:US
Mailing Address - Phone:812-425-3561
Mailing Address - Fax:812-463-4600
Practice Address - Street 1:610 E WALNUT ST
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47713-2460
Practice Address - Country:US
Practice Address - Phone:812-425-3561
Practice Address - Fax:812-463-4600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN150052471251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000323484OtherBLUE CROSS-PRINCETON OFF
IN201266990AMedicaid
IN000000323485OtherBLUE CROSS TELL CITY OFFI
ILV255P(657A5)1475OtherVA - MARION
IN000000186268OtherBLUE CROSS EVANSVILLE OFF
IN000000323484OtherBLUE CROSS-PRINCETON OFF
KY34340042OtherUNISY'S
IN000000323485OtherBLUE CROSS TELL CITY OFFI
IN000000186268OtherBLUE CROSS EVANSVILLE OFF
IN000000323484OtherBLUE CROSS-PRINCETON OFF
IL=========001Medicaid