Organization
MEDICAL CENTER AMBULANCE SERVICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN LUCK (DIRECTOR OF OPERATIONS)
(270) 821-1294
Entity
Organization
Contact information
Practice address
629 LAFFOON ST, MADISONVILLE, KY 42431-1624
(270) 821-1294
(270) 825-9452
Mailing address
PO BOX 9150, PADUCAH, KY 42002-9150
(270) 744-9600
(270) 744-0834
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
1413
KY
3416L0300X
Land Ambulance
Primary
1413
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4581387
—
TN
05
—
55054035
—
KY
05
—
56004351
—
KY
Enumeration date
07/04/2005
Last updated
02/07/2022
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