Provider Demographics
NPI:1124244835
Name:PERRY COUNTY COUNCIL ON AGING
Entity type:Organization
Organization Name:PERRY COUNTY COUNCIL ON AGING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EX. DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:E
Authorized Official - Last Name:SCHOENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-547-8115
Mailing Address - Street 1:P.O. BOX 163
Mailing Address - Street 2:
Mailing Address - City:CANNELTON
Mailing Address - State:IN
Mailing Address - Zip Code:47520-1104
Mailing Address - Country:US
Mailing Address - Phone:812-547-8115
Mailing Address - Fax:812-548-0722
Practice Address - Street 1:200 N 5TH ST
Practice Address - Street 2:
Practice Address - City:CANNELTON
Practice Address - State:IN
Practice Address - Zip Code:47520-1104
Practice Address - Country:US
Practice Address - Phone:812-547-8115
Practice Address - Fax:812-548-0722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN347C00000X
343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle