Provider Demographics
NPI:1467419283
Name:OWEN COUNTY FISCAL COURT
Entity Type:Organization
Organization Name:OWEN COUNTY FISCAL COURT
Other - Org Name:OWEN COUNTY EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COUNTY EXECUTIVE
Authorized Official - Prefix:
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:T
Authorized Official - Last Name:WOODYARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-484-3405
Mailing Address - Street 1:100 NORTH THOMAS STREET
Mailing Address - Street 2:
Mailing Address - City:OWENTON
Mailing Address - State:KY
Mailing Address - Zip Code:40359
Mailing Address - Country:US
Mailing Address - Phone:502-484-3405
Mailing Address - Fax:502-484-1004
Practice Address - Street 1:208 EAST BLANTON STREET
Practice Address - Street 2:
Practice Address - City:OWENTON
Practice Address - State:KY
Practice Address - Zip Code:40359
Practice Address - Country:US
Practice Address - Phone:502-484-5214
Practice Address - Fax:502-484-3958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-26
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY11413416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000070457OtherBLUE CROSS BLUE SHIELD
KY56004575NON-EMERGENCMedicaid
KY1080147Medicaid
KY1080147PASSPORTHEALTOtherPASSPORT HEALTH
KY55094015EMERGENCYMedicaid
KY55094015Medicaid
KS2435453000OtherPASSPORT ADVANTAGE
KS2435453000PASSPORTADOtherPASSPORT ADVANTAGE
KY56004575Medicaid
KS2435453000OtherPASSPORT ADVANTAGE
KY55094015EMERGENCYMedicaid