Organization
CITY OF MAYFIELD OFFICE OF CITY CLERK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY CREASON (DIRECTOR)
(270) 251-6240
Entity
Organization
Contact information
Practice address
104 N 6TH ST, MAYFIELD, KY 42066-1602
(270) 251-6248
(270) 251-9888
Mailing address
PO BOX 589, MADISONVILLE, KY 42431-5011
(270) 824-8123
(270) 824-8140
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
1009
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
406590071
RR MEDICARE
—
05
—
55042014
—
KY
05
—
56004286
—
KY
Enumeration date
07/04/2005
Last updated
02/22/2018
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