MEDICARE: JESSAMINE 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	1449	KY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	590007628	OTHER	KY	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	000000070456	OTHER	KY	ANTHEM

General Provider Information

NPI Number	:	1730181033
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JESSAMINE COUNTY FISCAL COURT

Provider Business Mailing Address
First Line	:	101 S 2ND ST STE B
Second Line	:
City	:	NICHOLASVILLE
State	:	KY
Zip	:	40356-1554
Country	:	US
Telephone Number	:	598-872-9878
Fax Number	:	859-881-0940

Provider Business Practice Location Address
First Line	:	101 S 2ND ST
Second Line	:
City	:	NICHOLASVILLE
State	:	KY
Zip	:	40356-1554
Country	:	US
Telephone Number	:	859-887-2987
Fax Number	:	859-881-0940

Authorized Official
Title or Position	:	DIRECTOR/ CHIEF
Name	:	JAMES GOODPASTER
Credential	:
Telephone Number	:	859-887-2987

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	02/15/2021

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Directions to “JESSAMINE COUNTY FISCAL COURT ” Practice Location

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