Organization
PORTSMOUTH AMBULANCE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN DEERE (VP OF OPERATIONS)
(606) 465-7373
Entity
Organization
Contact information
Practice address
1536 WINCHESTER AVE, ASHLAND, KY 41101-7662
(740) 353-7553
Mailing address
PO BOX 1860, ASHLAND, KY 41105-1860
(740) 353-7553
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
730102
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000186402
BLUE CROSS
OH
05
—
0780212
—
OH
05
—
55000285
—
KY
05
—
56017007
—
KY
01
—
59014451
RAILROAD MEDICARE
—
Enumeration date
04/12/2007
Last updated
12/21/2007
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