Provider Demographics
NPI:1558573469
Name:WOODRUFF COUNTY AGING PROGRAM INC
Entity Type:Organization
Organization Name:WOODRUFF COUNTY AGING PROGRAM INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNTY COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:J
Authorized Official - Last Name:HYATT
Authorized Official - Suffix:
Authorized Official - Credentials:ASOCIATES BUSINESS
Authorized Official - Phone:870-731-5053
Mailing Address - Street 1:PO BOX 39
Mailing Address - Street 2:
Mailing Address - City:PATTERSON
Mailing Address - State:AR
Mailing Address - Zip Code:72123-0039
Mailing Address - Country:US
Mailing Address - Phone:870-731-5053
Mailing Address - Fax:870-731-2408
Practice Address - Street 1:303 WEST HIGHWAY 17
Practice Address - Street 2:
Practice Address - City:PATTERSON
Practice Address - State:AR
Practice Address - Zip Code:72123
Practice Address - Country:US
Practice Address - Phone:870-731-5053
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals