Organization
ELKHORN AMBULANCE SERVICE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY THOMPSON (CHIEF)
(606) 754-5173
Entity
Organization
Contact information
Practice address
223 BRIDGE STREET, ELKHORN CITY, KY 41522
(606) 754-5173
(606) 754-5813
Mailing address
836 4TH AVE, HUNTINGTON, WV 25701-1407
(800) 676-4785
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
1658
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000389814
ANTHEM
KY
05
—
010223474
—
VA
01
—
1069699
WV WORKERS COMP
WV
05
—
2623138
—
OH
01
—
406590993
RR MEDICARE
KY
01
—
50008744
PASSPORT
KY
05
—
55001234
—
KY
05
—
56028855
—
KY
01
—
610830100
BLACK LUNG
KY
Enumeration date
02/17/2006
Last updated
11/30/2010
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