Basic Information
| Provider Information | |||||||||
| NPI: | 1699773515 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BATH COUNTY AMBULANCE DISTRICT | ||||||||
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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: | 78 ROWLAND AVE | ||||||||
| Address2: | |||||||||
| City: | OWINGSVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 403602013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6066748158 | ||||||||
| FaxNumber: | 6066742768 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2005 | ||||||||
| LastUpdateDate: | 02/08/2019 | ||||||||
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| AuthorizedOfficialLastName: | SMITH | ||||||||
| AuthorizedOfficialFirstName: | TIM | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 6066748158 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3416L0300X | Y | Transportation Services | Ambulance | Land Transport |
ID Information
| ID | Type | State | Issuer | Description | 590014359 | 01 | KY | RAILROAD MEDICARE | OTHER | 089022300 | 01 | KY | BLACK LUNG | OTHER | 200338400A | 05 | IN | MEDICAID | 55001598 | 05 | KY | MEDICAID | 000000070164 | 01 | KY | ANTHEM | OTHER | 000000011060 | 01 | KY | CHA | OTHER | 2279869 | 05 | OH | MEDICAID | 56031396 | 05 | KY | MEDICAID |