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Organization

ESTILL COUNTY EMS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DARREN G MUNCIE (DIRECTOR)
(606) 723-2124
Entity
Organization

Contact information

Practice address
22 MERCY COURT, IRVINE, KY 40336-9998
(606) 723-2124
(304) 521-1576
Mailing address
836 4TH AVE, HUNTINGTON, WV 25701-1407
(304) 521-1576
(304) 521-1576

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000070069
ANTHEM
KY
01
083445300
BLACK LUNG
KY
01
1143774
PASSPORT
KY
01
406590715
RR MEDICARE
KY
05
55033013
KY
05
56003916
KY
Enumeration date
07/14/2005
Last updated
10/04/2023
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