MEDICARE: ANCHORAGE AMBULANCE DISTRICT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	341600000X	Ambulance	1431	KY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
7	590011748	OTHER	KY	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2434468000	OTHER	KY	PASSPORT ADVANTAGE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1064754	OTHER	KY	PASSPORT
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	00001183289	OTHER	KY	CHA
8	000000070175	OTHER	KY	ANTHEM

General Provider Information

NPI Number	:	1376541201
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANCHORAGE AMBULANCE DISTRICT

Provider Business Mailing Address
First Line	:	836 4TH AVENUE
Second Line	:
City	:	HUNTINGTON
State	:	WV
Zip	:	25701
Country	:	US
Telephone Number	:	800-676-4785
Fax Number	:	304-522-4222

Provider Business Practice Location Address
First Line	:	1400 EVERGREEN RD
Second Line	:
City	:	ANCHORAGE
State	:	KY
Zip	:	40223-1418
Country	:	US
Telephone Number	:	502-245-6755
Fax Number	:	502-245-9029

Authorized Official
Title or Position	:	DEPUTY CHIEF/DIRECTOR
Name	:	KEITH BROOKS
Credential	:
Telephone Number	:	502-376-1278

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	12/12/2022

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Directions to “ANCHORAGE AMBULANCE DISTRICT ” Practice Location

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