MEDICARE: TRIMBLE COUNTY FISCAL COURT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance	1418	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2439746000	OTHER	KY	PASSPORT ADVANTAGE
3	1163332	OTHER	KY	PASSPORT HEALTH
4	000000261201	OTHER	KS	BLUE CROSS BLUE SHIELD
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619918984
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRIMBLE COUNTY FISCAL COURT

Provider Business Mailing Address
First Line	:	PO BOX 312
Second Line	:
City	:	BEDFORD
State	:	KY
Zip	:	40006
Country	:	US
Telephone Number	:	502-255-0062
Fax Number	:	502-255-0063

Provider Business Practice Location Address
First Line	:	4832 HWY 421 N
Second Line	:
City	:	BEDFORD
State	:	KY
Zip	:	40006
Country	:	US
Telephone Number	:	502-255-0062
Fax Number	:	502-255-0063

Authorized Official
Title or Position	:	TRIMBLE JUDGE EXECUTIVE
Name	:	RANDY KEITH STEVENS
Credential	:
Telephone Number	:	502-255-7196

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	08/22/2020

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Directions to “TRIMBLE COUNTY FISCAL COURT ” Practice Location

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