Basic Information
| Provider Information | |||||||||
| NPI: | 1083612907 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BOYD COUNTY AMBULANCE SERVICE DIST | ||||||||
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| Mailing Information | |||||||||
| Address1: | 836 4TH AVE | ||||||||
| Address2: | |||||||||
| City: | HUNTINGTON | ||||||||
| State: | WV | ||||||||
| PostalCode: | 257011407 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8006764785 | ||||||||
| FaxNumber: | 3045224222 | ||||||||
| Practice Location | |||||||||
| Address1: | 2758 GREENUP AVE | ||||||||
| Address2: | |||||||||
| City: | ASHLAND | ||||||||
| State: | KY | ||||||||
| PostalCode: | 411011953 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6063259702 | ||||||||
| FaxNumber: | 6063259703 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2005 | ||||||||
| LastUpdateDate: | 03/27/2013 | ||||||||
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| AuthorizedOfficialLastName: | ADAMS | ||||||||
| AuthorizedOfficialFirstName: | TOM | ||||||||
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| AuthorizedOfficialTitleorPosition: | CHIEF | ||||||||
| AuthorizedOfficialTelephone: | 6063259702 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 341600000X | 1386 | KY | Y | Transportation Services | Ambulance |
ID Information
| ID | Type | State | Issuer | Description | 163289800 | 01 | KY | FEDERAL DEPT OF LABOR | OTHER | 55000992 | 05 | KY | MEDICAID | 2426315 | 05 | OH | MEDICAID | 000000229915 | 01 | KY | ANTHEM BCBS | OTHER | 1054560 | 01 | WV | WV WORKERS COMP | OTHER | 0227001000 | 05 | WV | MEDICAID | 50003405 | 01 | KY | PASSPORT | OTHER | 163289800 | 01 | KY | BLACK LUNG | OTHER | 224865 | 01 | KY | CARELINK | OTHER | 406590608 | 01 | KY | RAILROAD MEDICARE | OTHER |