Provider Demographics
NPI:1083612907
Name:BOYD COUNTY AMBULANCE SERVICE DIST
Entity Type:Organization
Organization Name:BOYD COUNTY AMBULANCE SERVICE DIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:TOM
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-325-9702
Mailing Address - Street 1:836 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-1407
Mailing Address - Country:US
Mailing Address - Phone:800-676-4785
Mailing Address - Fax:304-522-4222
Practice Address - Street 1:2758 GREENUP AVE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-1953
Practice Address - Country:US
Practice Address - Phone:606-325-9702
Practice Address - Fax:606-325-9703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-13
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1386341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY163289800OtherFEDERAL DEPT OF LABOR
KY55000992Medicaid
OH2426315Medicaid
KY000000229915OtherANTHEM BCBS
WV1054560OtherWV WORKERS COMP
WV0227001000Medicaid
KY50003405OtherPASSPORT
KY163289800OtherBLACK LUNG
KY224865OtherCARELINK
KY406590608OtherRAILROAD MEDICARE
KY50003405OtherPASSPORT
OH=========00OtherOPH WORKERS COMP
WV0227001000Medicaid
KY163289800OtherFEDERAL DEPT OF LABOR