Healthcare Provider Details

I. General information

NPI: 1306897822
Provider Name (Legal Business Name): KENTON COUNTY AIRPORT BOARD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 05/22/2024
Certification Date: 05/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 TOWER DR
HEBRON KY
41048
US

IV. Provider business mailing address

PO BOX 392907
PITTSBURGH PA
15251-9907
US

V. Phone/Fax

Practice location:
  • Phone: 859-767-7959
  • Fax: 859-767-5993
Mailing address:
  • Phone: 800-962-1484
  • Fax: 859-767-5993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number1482
License Number StateKY

VIII. Authorized Official

Name: CANDICE S MCGRAW
Title or Position: CEO
Credential:
Phone: 859-767-7970