Organization
EDMONSON COUNTY AMBULANCE DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEITH SANDERS PARAMEDIC (DIRECTOR)
(270) 597-3721
Entity
Organization
Contact information
Practice address
1755 HWY 259 N., BROWNSVILLE, KY 42210-0118
(270) 597-3721
(270) 597-9851
Mailing address
PO BOX 118, BROWNSVILLE, KY 42210-0118
(270) 597-3721
(270) 597-9851
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
1519
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000077051
ANTHEM BC/BS
KY
01
—
163544600
U.S. DEPT. OF LABOR
KY
05
—
55031033
—
KY
05
—
56003874
—
KY
Enumeration date
10/20/2006
Last updated
12/22/2010
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