Provider Demographics
NPI:1124164074
Name:HICKMAN COUNTY SENIOR CITIZENS, INC.
Entity type:Organization
Organization Name:HICKMAN COUNTY SENIOR CITIZENS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:A
Authorized Official - Last Name:DERRYBERRY
Authorized Official - Suffix:
Authorized Official - Credentials:NONE
Authorized Official - Phone:931-729-2115
Mailing Address - Street 1:107 ARMORY ST
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37033-1517
Mailing Address - Country:US
Mailing Address - Phone:931-729-2115
Mailing Address - Fax:931-729-5486
Practice Address - Street 1:107 ARMORY ST
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37033-1517
Practice Address - Country:US
Practice Address - Phone:931-729-2115
Practice Address - Fax:931-729-5486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNT0000155343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)