Androscoggin Valley Home Care Services

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

01938 Issued in NH

Legal business name

ANDROSCOGGIN VALLEY HOME CARE SERVICES

Practice address

795 Main St
Berlin, NH 03570-2437

Phone

(603) 752-7505

Fax

(603) 752-4317

NPI assigned

Feb 26, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Margo C Sullivan, RN, BSN

Title

Executive Director

Phone

(603) 752-7505

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1982730693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "795 MAIN ST",
            "city": "BERLIN",
            "state": "NH",
            "postal_code": "035702437",
            "telephone_number": "603-752-7505",
            "fax_number": "603-752-4317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "795 MAIN ST",
            "city": "BERLIN",
            "state": "NH",
            "postal_code": "035702437",
            "telephone_number": "603-752-7505",
            "fax_number": "603-752-4317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDROSCOGGIN VALLEY HOME CARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "MARGO",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "603-752-7505",
        "authorized_official_credential": "RN, BSN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NH",
            "license": "01938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "99591005",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Berlin, NH
• Providers in Berlin, NH by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.