Organization
REGIONAL TRANSPORT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JILL P MCKIBBEN (CO-OWNER ASST DIRECTOR)
(606) 759-5993
Entity
Organization
Contact information
Practice address
1910 OLD MAIN, MAYSVILLE, KY 41056
(606) 759-5993
(606) 759-8426
Mailing address
PO BOX 164, WASHINGTON, KY 41096
(606) 759-5993
(606) 759-8426
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
1645
KY
3416L0300X
Land Ambulance
3003
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000224891
BLUE CROSS BLUE SHIELD
KY
05
—
1010495910001
—
PA
05
—
2323275
—
OH
01
—
2445746000
PASSPORT ADVANTAGE
KY
05
—
3810004113
—
WV
01
—
50004381
PASSPORT HEALTH
KY
01
—
55000608
MEDICAID UNISYS 55
KY
01
—
56021447
MEDICAID UNISYS 56
KY
01
—
800434
BLACK LUNG
KY
01
—
8050401
FEDERAL MEDICARE
KY
Enumeration date
04/26/2006
Last updated
08/22/2020
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