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Organization

LARUE COUNTY COUNTY TREASURER

Active
Other names
Larue County EMS
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL S COTTRELL (DIRECTOR)
(270) 358-4071
Entity
Organization

Contact information

Practice address
924 S LINCOLN BLVD, HODGENVILLE, KY 42748
(270) 358-4071
(270) 358-4093
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
1361
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000070448
BLUE CROSS BLUE SHIELD
KY
01
1074427
PASSPORT HEALTH
KY
01
2435164000
PASSPORT ADVANTAGE
KY
01
55062012
MEDICAID UNISYS 55
KY
01
56005432
MEDICAID UNISYS 56
KY
01
590003506
RAILROAD MEDICARE
KY
Enumeration date
07/17/2006
Last updated
07/18/2023
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