Healthcare Provider Details
I. General information
NPI: 1881693638
Provider Name (Legal Business Name): ESTILL COUNTY EMS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/14/2005
Last Update Date: 10/04/2023
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
22 MERCY COURT
IRVINE KY
40336-9998
US
IV. Provider business mailing address
836 4TH AVE
HUNTINGTON WV
25701-1407
US
V. Phone/Fax
- Phone: 606-723-2124
- Fax: 304-521-1576
- Phone: 304-521-1576
- Fax: 304-521-1576
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3416L0300X |
| Taxonomy | Land Ambulance |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DARREN
G
MUNCIE
Title or Position: DIRECTOR
Credential:
Phone: 606-723-2124