Healthcare Provider Details

I. General information

NPI: 1922083021
Provider Name (Legal Business Name): MORGAN COUNTY AMBULANCE TAXING DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2005
Last Update Date: 02/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412 DOGWOOD LN
WEST LIBERTY KY
41472-1259
US

IV. Provider business mailing address

PO BOX 589
MADISONVILLE KY
42431-5011
US

V. Phone/Fax

Practice location:
  • Phone: 606-743-7490
  • Fax: 606-743-2700
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 Number1167
License Number StateKY

VIII. Authorized Official

Name: MR. FLORA LOCKERMAN
Title or Position: DIRECTOR
Credential:
Phone: 606-743-7490