Organization
CITY OF CAMPBELLSVILLE KY
Active
Other names
Campbellsville Taylor County EMS
Organization subpart
No
Provider details
NPI number
Authorized official
TONY YOUNG (MAYOR)
(270) 465-3504
Entity
Organization
Contact information
Practice address
105 SOUTH COLUMBIA AVE, CAMPBELLSVILLE, KY 42718-1337
(270) 465-6717
(270) 789-3135
Mailing address
836 4TH AVE, HUNTINGTON, WV 25701-1407
(800) 676-4785
(304) 522-4222
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000340594
ANTHEM
KY
01
—
086909900
BLACK LUNG
KY
01
—
1063010
PASSPORT
KY
05
—
1864176
—
TN
05
—
200201650A
—
IN
01
—
2445149000
PASSPORT ADVANTAGE
KY
05
—
2645221
—
OH
05
—
55001101
—
KY
05
—
56027774
—
KY
01
—
P00248582
RAILROAD MEDICARE
KY
Enumeration date
07/14/2005
Last updated
02/08/2019
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