1083612907 NPI number — BOYD COUNTY AMBULANCE SERVICE DIST

Table of content: (NPI 1083612907)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083612907 NPI number — BOYD COUNTY AMBULANCE SERVICE DIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BOYD COUNTY AMBULANCE SERVICE DIST
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:
Provider Other Organization Name Type Code:
6
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:
1083612907
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/15/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
836 4TH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUNTINGTON
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
25701-1407
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-521-1576
Provider Business Mailing Address Fax Number:
304-521-1576

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2758 GREENUP AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ASHLAND
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41101-1953
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-325-9702
Provider Business Practice Location Address Fax Number:
606-393-3315
Provider Enumeration Date:
07/13/2005

Additional Information

Authorized Official

Authorized Official Last Name:
TURVEY
Authorized Official First Name:
BRENT
Authorized Official Middle Name:
Authorized Official Title or Position:
EMS DIRECTOR
Authorized Official Telephone Number:
606-325-9702

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  1386 , 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: 224865 . This is a "CARELINK" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 55000921 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000229915 . This is a "ANTHEM BCBS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 163289800 . This is a "BLACK LUNG" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 50003405 . This is a "PASSPORT" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 0227001000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 163289800 . This is a "FEDERAL DEPT OF LABOR" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 406590608 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 55000992 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1054560 . This is a "WV WORKERS COMP" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 2426315 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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