Organization
MONROE MEDICAL FOUNDATION, INC.
Active
Other names
Monroe County Ambulance Service
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VICKY MCFALL (CHIEF EXECUTIVE OFFICER)
(270) 487-9231
Entity
Organization
Contact information
Practice address
429 CAPP HARLAN RD, TOMPKINSVILLE, KY 42167-1808
(270) 487-8083
(270) 487-8083
Mailing address
529 CAPP HARLAN RD, TOMPKINSVILLE, KY 42167-1808
(270) 487-9231
(270) 487-5784
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
1072
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4064001
TENNCARE SELECT
TN
05
—
55086011
—
KY
Enumeration date
11/27/2006
Last updated
08/22/2020
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