Organization
MONROE MEDICAL FOUNDATION, INC.
Active
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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