MEDICARE: BKP 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	146L00000X	Paramedic	51424493	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	144529XX	OTHER	OH	PREFERRED CARE HMO
2	000000155404	OTHER	OH	ANTHEM
3	0004504855	OTHER	OH	AETNA
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538166400
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BKP AMBULANCE DISTRICT

Provider Business Mailing Address
First Line	:	439 S MAIN ST
Second Line	:
City	:	KENTON
State	:	OH
Zip	:	43326-1946
Country	:	US
Telephone Number	:	419-674-4574
Fax Number	:	419-673-1024

Provider Business Practice Location Address
First Line	:	439 S MAIN ST
Second Line	:
City	:	KENTON
State	:	OH
Zip	:	43326-1946
Country	:	US
Telephone Number	:	419-674-4574
Fax Number	:	419-673-1024

Authorized Official
Title or Position	:	OPERATIONS SUPERVISOR
Name	:	CHESTER E MILLS
Credential	:
Telephone Number	:	419-674-4574

Provider Enumeration Date	:	07/06/2005
Last Update Date	:	05/05/2015

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Directions to “BKP AMBULANCE DISTRICT ” Practice Location

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