Healthcare Provider Details

I. General information

NPI: 1174552335
Provider Name (Legal Business Name): CITY OF DRY RIDGE KENTUCKY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2006
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 RACE ST PO BOX 145
DRY RIDGE KY
41035-0145
US

IV. Provider business mailing address

PO BOX 392907
PITTSBURGH PA
15251-9907
US

V. Phone/Fax

Practice location:
  • Phone: 859-824-9158
  • Fax: 859-824-9160
Mailing address:
  • Phone: 800-962-1484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number1641
License Number StateKY

VIII. Authorized Official

Name: MR. KEVIN STAVE
Title or Position: EMS COORDINATOR
Credential: FIRE FIGHTER PARAMED
Phone: 859-824-9158