Provider Demographics
NPI:1932255767
Name:ORANGEBURG COUNTY COUNCIL ON AGING
Entity Type:Organization
Organization Name:ORANGEBURG COUNTY COUNCIL ON AGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERYL
Authorized Official - Middle Name:S
Authorized Official - Last Name:JEFFCOAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-531-4663
Mailing Address - Street 1:PO BOX 1301
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29116-1301
Mailing Address - Country:US
Mailing Address - Phone:803-531-4663
Mailing Address - Fax:803-533-5883
Practice Address - Street 1:2570 SAINT MATTHEWS RD
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29118-1320
Practice Address - Country:US
Practice Address - Phone:803-531-4663
Practice Address - Fax:803-533-5883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2189251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCEX0330Medicaid