Provider Demographics
NPI:1730186701
Name:VISITING NURSE CORPORATION OF COLORADO INC.
Entity type:Organization
Organization Name:VISITING NURSE CORPORATION OF COLORADO INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:J
Authorized Official - Last Name:REILLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-698-2121
Mailing Address - Street 1:5373 N UNION BLVD
Mailing Address - Street 2:STE 101
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-2073
Mailing Address - Country:US
Mailing Address - Phone:719-577-4448
Mailing Address - Fax:719-577-4082
Practice Address - Street 1:5373 N UNION BLVD
Practice Address - Street 2:STE 101
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-2073
Practice Address - Country:US
Practice Address - Phone:719-577-4448
Practice Address - Fax:719-577-4082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-05
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO83307010Medicaid
CO067302Medicare PIN
CO067302Medicare ID - Type UnspecifiedCO SPRINGS PROVIDER