Organization
PENDLETON COUNTY FISCAL COURT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HENRY BERTRAM (CHIEF)
(859) 654-4321
Entity
Organization
Contact information
Practice address
705 W SHELBY ST, FALMOUTH, KY 41040-1037
(859) 654-4321
(859) 654-5047
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
1599
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000039195
ANTHEM
KY
05
—
0843896
—
OH
05
—
55096036
—
KY
Enumeration date
07/18/2005
Last updated
04/20/2008
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