Provider Demographics
NPI:1356460307
Name:COUNTY OF CHENANGO
Entity Type:Organization
Organization Name:COUNTY OF CHENANGO
Other - Org Name:CHENANGO COUNTY AREA AGENCY ON AGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:S
Authorized Official - Last Name:SANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-337-1770
Mailing Address - Street 1:5 COURT ST
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:NY
Mailing Address - Zip Code:13815-1695
Mailing Address - Country:US
Mailing Address - Phone:607-337-1770
Mailing Address - Fax:607-337-1749
Practice Address - Street 1:5 COURT ST
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:NY
Practice Address - Zip Code:13815-1695
Practice Address - Country:US
Practice Address - Phone:607-337-1770
Practice Address - Fax:607-337-1749
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF CHENANGO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY55183BMedicare ID - Type Unspecified