MEDICARE: ALLENS AMBULANCE SERVICE INC

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	1302	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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891792362
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLENS AMBULANCE SERVICE INC

Provider Business Mailing Address
First Line	:	PO BOX 83
Second Line	:	83 MAIN STREET
City	:	BOONEVILLE
State	:	KY
Zip	:	41314-0083
Country	:	US
Telephone Number	:	606-593-5849
Fax Number	:	606-593-5237

Provider Business Practice Location Address
First Line	:	83 MAIN STREET
Second Line	:
City	:	BOONEVILLE
State	:	KY
Zip	:	41314
Country	:	US
Telephone Number	:	606-593-5849
Fax Number	:	606-593-5237

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. PATRICIA ANN CAMPBELL
Credential	:
Telephone Number	:	606-593-5849

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	07/27/2007

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Directions to “ALLENS AMBULANCE SERVICE INC ” Practice Location

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