Healthcare Provider Details

I. General information

NPI: 1558368969
Provider Name (Legal Business Name): COUNTY OF NELSON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2005
Last Update Date: 01/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 ATKINSON HILL AVE
BARDSTOWN KY
40004-7770
US

IV. Provider business mailing address

PO BOX 578
BARDSTOWN KY
40004-0578
US

V. Phone/Fax

Practice location:
  • Phone: 502-348-4929
  • Fax: 502-348-2852
Mailing address:
  • Phone: 502-348-4929
  • Fax: 502-348-2852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number1363
License Number StateKY

VIII. Authorized Official

Name: MRS. WANDA F WARD
Title or Position: OFFICE MANAGER
Credential:
Phone: 502-348-4929