Organization
LEE COUNTY FISCAL COURT
Active
Other names
Citizens of Lee County Ambulance Service
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE WHEELER (PROVIDER RELATIONS SPECIALIST)
(304) 521-1576
Entity
Organization
Contact information
Practice address
18 WALNUT STREET, BEATTYVILLE, KY 41311
(606) 464-9288
(606) 464-4145
Mailing address
836 4TH AVENUE, HUNTINGTON, WV 25701-1407
(304) 521-1576
(304) 521-1768
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
1202
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000070476
ANTHEM BC BS
KY
05
—
55065015
—
KY
05
—
56003726
—
KY
01
—
590587046
RAILROAD MEDICARE ID NO.
KY
Enumeration date
11/21/2005
Last updated
04/04/2012
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