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General NPI Number Information
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NPI Number | 1508095639
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Entity Type | Organization
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Legal Business Name | KENTUCKY MEDICAL LOGISTICS INC
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Dates
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Enumeration Date | 07/10/2009
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Last Update Date | 08/17/2016
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Provider Practice Location Address
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Address Line | 425 22ND STREET
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City | ASHLAND
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State | KY
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Zip | 41102
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Country | US
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Telephone | 606-408-2900
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Fax | 606-408-6008
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Provider Business Mailing Address
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Address Line | 425 22ND STREET
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City | ASHLAND
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State | KY
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Zip | 41102
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Country | US
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Telephone | 606-408-2900
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Fax | 606-408-6008
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | KRISTIE M WHITLATCH
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Credential |
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Telephone | 606-408-4405
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 1673
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State | KY
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