Healthcare Provider Details

I. General information

NPI: 1336313956
Provider Name (Legal Business Name): PEPIN COUNTY OFFICE OF AGING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2008
Last Update Date: 04/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 W MADISON ST
DURAND WI
54736-1025
US

IV. Provider business mailing address

606 W MADISON ST
DURAND WI
54736-1025
US

V. Phone/Fax

Practice location:
  • Phone: 715-672-8936
  • Fax: 715-672-3598
Mailing address:
  • Phone: 715-672-8936
  • Fax: 715-672-3598

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MS. JENNIFER B HATTEN
Title or Position: INTERIM DIRECTOR
Credential:
Phone: 715-672-8936