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General NPI Number Information
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NPI Number | 1922083021
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Entity Type | Organization
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Legal Business Name | MORGAN COUNTY AMBULANCE TAXING DISTRICT
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Dates
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Enumeration Date | 12/12/2005
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Last Update Date | 02/26/2018
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Provider Practice Location Address
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Address Line | 412 DOGWOOD LN
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City | WEST LIBERTY
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State | KY
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Zip | 41472-1259
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Country | US
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Telephone | 606-743-7490
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Fax | 606-743-2700
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Provider Business Mailing Address
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Address Line | PO BOX 589
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City | MADISONVILLE
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State | KY
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Zip | 42431-5011
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Country | US
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Telephone | 270-824-8123
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Fax | 270-824-8140
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. FLORA LOCKERMAN
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Credential |
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Telephone | 606-743-7490
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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 | 1167
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License Number State | KY
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