Provider Demographics
NPI:1730225541
Name:SHELBYVILLE BEDFORD COUNTY SENIOR CITIZENS CENTER
Entity type:Organization
Organization Name:SHELBYVILLE BEDFORD COUNTY SENIOR CITIZENS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-684-0019
Mailing Address - Street 1:111 JG HELTON DR
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37160-7422
Mailing Address - Country:US
Mailing Address - Phone:931-684-0019
Mailing Address - Fax:931-684-0086
Practice Address - Street 1:111 JG HELTON DR
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37160-7422
Practice Address - Country:US
Practice Address - Phone:931-684-0019
Practice Address - Fax:931-684-0086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNT000161Medicaid