Provider Demographics
NPI:1356027098
Name:FAIRFIELD COUNTY COUNCIL ON AGING
Entity type:Organization
Organization Name:FAIRFIELD COUNTY COUNCIL ON AGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:MATTOX
Authorized Official - Last Name:DOUGLAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-635-3015
Mailing Address - Street 1:210 E WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:WINNSBORO
Mailing Address - State:SC
Mailing Address - Zip Code:29180-1048
Mailing Address - Country:US
Mailing Address - Phone:803-635-3015
Mailing Address - Fax:803-718-9171
Practice Address - Street 1:210 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WINNSBORO
Practice Address - State:SC
Practice Address - Zip Code:29180-1048
Practice Address - Country:US
Practice Address - Phone:803-635-3015
Practice Address - Fax:803-718-9171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333300000XSuppliersEmergency Response System Companies