Organization
MONTGOMERY COUNTY AMBULANCE
Active
Organization
MONTGOMERY COUNTY AMBULANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY POTTER (CHIEF)
(859) 498-1318
Entity
Organization
Contact information
Practice address
805 INDIAN MOUND DRIVE, MT STERLING, KY 40353-1151
(859) 498-1318
(859) 498-3809
Mailing address
836 4TH AVE, HUNTINGTON, WV 25701-1407
(800) 676-4785
(304) 522-4222
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
1445
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000070315
ANTHEM
KY
05
—
200528290A
—
IN
05
—
2593297
—
OH
01
—
50005079
PASSPORT
KY
05
—
55087043
—
KY
05
—
56004435
—
KY
01
—
590001325
RAILROAD MEDICARE
KY
01
—
606386600
BLACK LUNG
KY
01
—
610988811
TRICARE
KY
Enumeration date
07/13/2005
Last updated
03/15/2011
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