Organization
GREEN COUNTY AMBULANCE SERVICE TAXING DISTRICT
Active
Other names
Green County Ambulance Service
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICK CHEATHAM (DIRECTOR)
(270) 932-7414
Entity
Organization
Contact information
Practice address
55 DAKOTA MEYER DR, GREENSBURG, KY 42743-1451
(270) 932-7414
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
1467
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000070265
BLUE CROSS BLUE SHIELD
KY
01
—
1068230
PASSPORT HEALTH
KY
01
—
2434679000
PASSPORT ADVANTAGE
KY
05
—
55044028
—
KY
05
—
56004005
—
KY
01
—
709849300
DOL - FECA / BL/ ENERGY
KY
Enumeration date
04/26/2006
Last updated
11/22/2021
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