Provider Demographics
NPI:1124149463
Name:FRANKLIN COUNTY DEPARTMENT OF AGING SERVICES
Entity type:Organization
Organization Name:FRANKLIN COUNTY DEPARTMENT OF AGING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:N
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-483-9238
Mailing Address - Street 1:136 TANYARD RD
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:VA
Mailing Address - Zip Code:24151-1516
Mailing Address - Country:US
Mailing Address - Phone:540-483-9238
Mailing Address - Fax:540-489-6264
Practice Address - Street 1:136 TANYARD RD
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:VA
Practice Address - Zip Code:24151-1516
Practice Address - Country:US
Practice Address - Phone:540-483-9238
Practice Address - Fax:540-489-6264
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA344600000X, 343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No344600000XTransportation ServicesTaxi
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA9030646Medicaid
VA9042415Medicaid