Healthcare Provider Details

I. General information

NPI: 1457358632
Provider Name (Legal Business Name): CITY OF PROVIDENCE OFFICE OF TREASURER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2005
Last Update Date: 10/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 N WILLOW ST
PROVIDENCE KY
42450-1273
US

IV. Provider business mailing address

PO BOX 589
MADISONVILLE KY
42431-5011
US

V. Phone/Fax

Practice location:
  • Phone: 270-667-2011
  • Fax: 270-667-2012
Mailing address:
  • Phone: 270-824-8123
  • Fax: 270-824-8140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number1331
License Number StateKY

VIII. Authorized Official

Name: MR. BRAD CURRY
Title or Position: DIRECTOR
Credential:
Phone: 270-667-2011