1659448843 NPI number — MADISON COUNTY BOARD OF COMMISSIONERS HDM

Table of content: (NPI 1659448843)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659448843 NPI number — MADISON COUNTY BOARD OF COMMISSIONERS HDM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MADISON COUNTY BOARD OF COMMISSIONERS HDM
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
MADISON COUNTY SENIOR CENTER
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1659448843
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/23/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 777
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DANIELSVILLE
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30633-0777
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1265 98 WEST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DANIELSVILLE
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30633
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-795-2542
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WYATT
Authorized Official First Name:
CHERRI
Authorized Official Middle Name:
MAE
Authorized Official Title or Position:
BILLING SPECIALIST
Authorized Official Telephone Number:
706-795-6307

Provider Taxonomy Codes

  • Taxonomy code: 332U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000610046A . This is a "MADISON CO BRD OF COMMISS" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com