1619918984 NPI number — TRIMBLE COUNTY FISCAL COURT

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619918984 NPI number — TRIMBLE COUNTY FISCAL COURT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TRIMBLE COUNTY FISCAL COURT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
TRIMBLE CO EMS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1619918984
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 312
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BEDFORD
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40006
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-255-0062
Provider Business Mailing Address Fax Number:
502-255-0063

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4832 HWY 421 N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BEDFORD
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-255-0062
Provider Business Practice Location Address Fax Number:
502-255-0063
Provider Enumeration Date:
06/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
STEVENS
Authorized Official First Name:
RANDY
Authorized Official Middle Name:
KEITH
Authorized Official Title or Position:
TRIMBLE JUDGE EXECUTIVE
Authorized Official Telephone Number:
502-255-7196

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  1418 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 55000541 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2439746000 . This is a "PASSPORT ADVANTAGE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 1163332 . This is a "PASSPORT HEALTH" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 000000261201 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 56027279 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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