Healthcare Provider Details

I. General information

NPI: 1891877353
Provider Name (Legal Business Name): EDMONSON COUNTY AMBULANCE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 12/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1755 HWY 259 N.
BROWNSVILLE KY
42210-0118
US

IV. Provider business mailing address

PO BOX 118
BROWNSVILLE KY
42210-0118
US

V. Phone/Fax

Practice location:
  • Phone: 270-597-3721
  • Fax: 270-597-9851
Mailing address:
  • Phone: 270-597-3721
  • Fax: 270-597-9851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number1519
License Number StateKY

VIII. Authorized Official

Name: MR. KEITH SANDERS
Title or Position: DIRECTOR
Credential: PARAMEDIC
Phone: 270-597-3721