Provider Demographics
NPI:1164568499
Name:PERRY COUNTY COUNCIL ON AGING
Entity Type:Organization
Organization Name:PERRY COUNTY COUNCIL ON AGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIANNE
Authorized Official - Middle Name:HEDRICK
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-589-5111
Mailing Address - Street 1:P. O. BOX 367
Mailing Address - Street 2:112 SOUTH MILL ST.
Mailing Address - City:LINDEN
Mailing Address - State:TN
Mailing Address - Zip Code:37096-0367
Mailing Address - Country:US
Mailing Address - Phone:931-589-5111
Mailing Address - Fax:931-589-3375
Practice Address - Street 1:112 SOUTH MILL ST.
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:TN
Practice Address - Zip Code:37096
Practice Address - Country:US
Practice Address - Phone:931-589-5111
Practice Address - Fax:931-589-3375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNT000154OtherPROVIDER NO. TN CARE