Organization
WAYNE COUNTY FISCAL COURT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERWIN CORDER (CHIEF)
(606) 348-3301
Entity
Organization
Contact information
Practice address
111 JIM HILL SERVICE RD, MONTICELLO, KY 42633-7901
(606) 348-3301
(606) 348-3304
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
1648
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000328512
ANTHEM
KY
05
—
2502518
—
OH
01
—
2626308000
PASSPORT ADVANTAGE
KY
05
—
4287026
—
TN
01
—
50008672
PASSPORT
KY
05
—
55000970
—
KY
05
—
56026529
—
KY
01
—
610617500
BLACK LUNG
KY
01
—
P00300479
RAILROAD MEDICARE
KY
Enumeration date
07/22/2005
Last updated
04/28/2009
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