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Organization

OLDHAM COUNTY AMBULANCE TAXING DISTRICT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
THOMAS CLARK (VICE CHAIRMAN OF BOARD)
(502) 222-2890
Entity
Organization

Contact information

Practice address
1101 NEW MOODY LN, LA GRANGE, KY 40031-9124
(502) 222-7250
(502) 222-7282
Mailing address
PO BOX 589, MADISONVILLE, KY 42431-5011
(270) 824-8123
(270) 824-8140

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
1633
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000070284
ANTHEM BLUE CROSS
KY
01
1092934
PASSPORT
KY
05
55093058
KY
05
56015712
KY
01
590012776
RAILROAD MEDICARE
KY
01
98088
COVENTRY HEALTH MEDICAID MCO
KY
Enumeration date
01/16/2007
Last updated
03/17/2018
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