Provider Demographics
NPI:1215198502
Name:VERMILION COUNCIL ON AGING, INC.
Entity Type:Organization
Organization Name:VERMILION COUNCIL ON AGING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:RACHAEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:AUGUST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-893-2563
Mailing Address - Street 1:PO BOX 543
Mailing Address - Street 2:
Mailing Address - City:ABBEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70511-0543
Mailing Address - Country:US
Mailing Address - Phone:337-893-2563
Mailing Address - Fax:337-898-3397
Practice Address - Street 1:1928 GRACELAND AVE
Practice Address - Street 2:
Practice Address - City:ABBEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70510-3930
Practice Address - Country:US
Practice Address - Phone:337-893-2563
Practice Address - Fax:337-898-3397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-19
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1978418Medicaid