Organization
CASEY CO AMBULANCE TAX BOARD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MALCOLM MILLER (DIRECTOR)
(606) 787-8350
Entity
Organization
Contact information
Practice address
1167 CAMPBELLSVILLE ST, LIBERTY, KY 42539-3367
(606) 787-8350
Mailing address
836 4TH AVE, HUNTINGTON, WV 25701-1407
(800) 676-4785
(304) 522-4222
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
1327
KY
3416L0300X
Land Ambulance
1327
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000190651
ANTHEM
KY
01
—
000001165698
CHA
KY
01
—
1088661
PASSPORT
KY
01
—
2435839000
PASSPORT ADVANTAGE
KY
05
—
55023022
—
KY
05
—
56003676
—
KY
01
—
590013070
RAILROAD MEDICARE
KY
Enumeration date
07/14/2005
Last updated
06/17/2016
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