Provider Demographics
NPI:1225099534
Name:GEORGETOWN-SCOTT COUNTY AMBULANCE SERVICE
Entity Type:Organization
Organization Name:GEORGETOWN-SCOTT COUNTY AMBULANCE SERVICE
Other - Org Name:GEORGETOWN-SCOTT COUNTY EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:RUNYON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-863-7841
Mailing Address - Street 1:141 SOUTH BROADWAY STREET
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40324
Mailing Address - Country:US
Mailing Address - Phone:502-863-7841
Mailing Address - Fax:502-863-7843
Practice Address - Street 1:141 SOUTH BROADWAY STREET
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324
Practice Address - Country:US
Practice Address - Phone:502-863-7841
Practice Address - Fax:502-863-7843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-29
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY13373416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY2442684000OtherPASSPORT ADVANTAGE
KY55105019Medicaid
KY50001044OtherPASSPORT HEALTH
KY56007867Medicaid
KYP00013340OtherRAILROAD MEDICARE
IN200525820AMedicaid
KY000000070405OtherBLUE CROSS BLUE SHIELD
OH2540389Medicaid
IN200525820AMedicaid