Provider Demographics
NPI:1205080173
Name:PICKAWAY COUNTY COMMUNITY ACTION ORG; INC.
Entity type:Organization
Organization Name:PICKAWAY COUNTY COMMUNITY ACTION ORG; INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:HANNAHS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-477-1655
Mailing Address - Street 1:469 E OHIO ST
Mailing Address - Street 2:
Mailing Address - City:CIRCLEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43113-2034
Mailing Address - Country:US
Mailing Address - Phone:740-477-1655
Mailing Address - Fax:740-477-5735
Practice Address - Street 1:469 E OHIO ST
Practice Address - Street 2:
Practice Address - City:CIRCLEVILLE
Practice Address - State:OH
Practice Address - Zip Code:43113-2034
Practice Address - Country:US
Practice Address - Phone:740-477-1655
Practice Address - Fax:740-477-5735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-05
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)