Healthcare Provider Details

I. General information

NPI: 1336231224
Provider Name (Legal Business Name): APPALACHIAN FIRST RESPONSE EMERGENCY SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 01/17/2023
Certification Date: 01/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1477 POND CREEK RD
STONE KY
41567-7055
US

IV. Provider business mailing address

180 HOSPITAL DR BOX 1E
SOUTH WILLIAMSON KY
41503
US

V. Phone/Fax

Practice location:
  • Phone: 606-353-9834
  • Fax:
Mailing address:
  • Phone: 606-353-9835
  • Fax: 606-353-9834

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number1428
License Number StateKY

VIII. Authorized Official

Name: JERRY HURLEY
Title or Position: CFO
Credential:
Phone: 606-353-9835