MEDICARE: CENTRAL CAMPBELL COUNTY FIRE 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	1560	KY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	590014761	OTHER	KY	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	000000216161	OTHER	KY	ANTHEM
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	080648900	OTHER	KY	BLACK LUNG
7	CHOICE CARE C3569	OTHER	KY	CHOICE CARE

General Provider Information

NPI Number	:	1598764334
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL CAMPBELL COUNTY FIRE DISTRICT

Provider Business Mailing Address
First Line	:	PO BOX 392907
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15251
Country	:	US
Telephone Number	:	800-962-1484
Fax Number	:	513-772-4464

Provider Business Practice Location Address
First Line	:	4113 ALEXANDRIA PIKE
Second Line	:
City	:	COLD SPRING
State	:	KY
Zip	:	41076-1819
Country	:	US
Telephone Number	:	859-441-7631
Fax Number	:	859-781-5115

Authorized Official
Title or Position	:	CHIEF
Name	:	DANIEL G SCHULTZ
Credential	:
Telephone Number	:	859-441-7631

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	10/11/2021

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Directions to “CENTRAL CAMPBELL COUNTY FIRE DISTRICT ” Practice Location

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