Provider Demographics
NPI:1164618765
Name:CHEROKEE COUNTY SENIOR SERVICES
Entity Type:Organization
Organization Name:CHEROKEE COUNTY SENIOR SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SITE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:PEGGY GRAHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-837-2467
Mailing Address - Street 1:69 ALPINE ST
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:NC
Mailing Address - Zip Code:28906-2951
Mailing Address - Country:US
Mailing Address - Phone:828-837-2467
Mailing Address - Fax:828-837-1938
Practice Address - Street 1:69 ALPINE ST
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:NC
Practice Address - Zip Code:28906-2951
Practice Address - Country:US
Practice Address - Phone:828-837-2467
Practice Address - Fax:828-837-1938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-18
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3409195Medicaid