Organization
CITY OF FORT MITCHELL OFFICE OF TREASURER
Active
Other names
Fort Mitchell Life Squad
Organization subpart
No
Provider details
NPI number
Authorized official
ADAM L FULLER (CHIEF)
(859) 331-1267
Entity
Organization
Contact information
Practice address
2355 DIXIE HWY, FT MITCHELL, KY 41017-2948
(859) 331-1267
(859) 331-6102
Mailing address
PO BOX 9150, PADUCAH, KY 42002-9150
(270) 744-9600
(270) 744-8642
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000039205
ANTHEM
KY
01
—
000001199826
CHA
KY
05
—
2513613
—
OH
05
—
55059166
—
KY
Enumeration date
07/14/2005
Last updated
03/12/2021
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