Provider Demographics
NPI:1386661049
Name:LARUE COUNTY COUNTY TREASURER
Entity Type:Organization
Organization Name:LARUE COUNTY COUNTY TREASURER
Other - Org Name:LARUE COUNTY EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:COTTRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-358-4071
Mailing Address - Street 1:PO BOX 589
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42431-5011
Mailing Address - Country:US
Mailing Address - Phone:270-824-8123
Mailing Address - Fax:270-824-8140
Practice Address - Street 1:924 S LINCOLN BLVD
Practice Address - Street 2:
Practice Address - City:HODGENVILLE
Practice Address - State:KY
Practice Address - Zip Code:42748
Practice Address - Country:US
Practice Address - Phone:270-358-4071
Practice Address - Fax:270-358-4093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY13613416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1074427OtherPASSPORT HEALTH
KY000000070448OtherBLUE CROSS BLUE SHIELD
KY2435164000OtherPASSPORT ADVANTAGE
KY590003506OtherRAILROAD MEDICARE
KY55062012OtherMEDICAID UNISYS 55
KY56005432OtherMEDICAID UNISYS 56
KY1074427OtherPASSPORT HEALTH