Provider Demographics
NPI:1588266944
Name:VAN WERT COUNTY COUNCIL ON AGING, INC.
Entity type:Organization
Organization Name:VAN WERT COUNTY COUNCIL ON AGING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-238-5011
Mailing Address - Street 1:220 FOX RD
Mailing Address - Street 2:
Mailing Address - City:VAN WERT
Mailing Address - State:OH
Mailing Address - Zip Code:45891-2452
Mailing Address - Country:US
Mailing Address - Phone:419-238-5011
Mailing Address - Fax:419-238-5054
Practice Address - Street 1:220 FOX RD
Practice Address - Street 2:
Practice Address - City:VAN WERT
Practice Address - State:OH
Practice Address - Zip Code:45891-2452
Practice Address - Country:US
Practice Address - Phone:419-238-5011
Practice Address - Fax:419-238-5054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-11
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)