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General NPI Number Information
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NPI Number | 1710980347
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Entity Type | Organization
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Legal Business Name | BRACKEN COUNTY AMBULANCE DISTRICT
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Dates
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Enumeration Date | 05/27/2005
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Last Update Date | 06/18/2024
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Provider Practice Location Address
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Address Line | 592 BLADESTON DRIVE
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City | BROOKSVILLE
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State | KY
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Zip | 41004-8123
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Country | US
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Telephone | 606-735-3783
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Fax | 606-735-2694
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Provider Business Mailing Address
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Address Line | 836 4TH AVE
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City | HUNTINGTON
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State | WV
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Zip | 25701-1407
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Country | US
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Telephone | 304-521-1576
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Fax | 304-521-1576
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Authorized Official
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Title or Position | DIRECTOR
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Name | PENNY DOYLE
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Credential |
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Telephone | 606-735-3783
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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 | 1145
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number |
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License Number State |
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