Provider Demographics
NPI:1508823857
Name:LEXINGTON FAYETTE URBAN COUNTY GOVERNMENT
Entity Type:Organization
Organization Name:LEXINGTON FAYETTE URBAN COUNTY GOVERNMENT
Other - Org Name:LFUCG FIRE DEPARTMENT AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLBROOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-231-5600
Mailing Address - Street 1:PO BOX 9150
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42002-9150
Mailing Address - Country:US
Mailing Address - Phone:270-744-8413
Mailing Address - Fax:270-744-8642
Practice Address - Street 1:219 E THIRD ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40507
Practice Address - Country:US
Practice Address - Phone:859-231-5643
Practice Address - Fax:859-231-5652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-28
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY12883416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000070013OtherBLUE CROSS BLUE SHIELD
KY55034029Medicaid
KY2435509000OtherPASSPORT ADVANTAGE
KY406590461OtherRAILROAD MEDICARE
KY1081349OtherPASSPORT HEALTH
FL913088800Medicaid
OH2518574Medicaid
KY000000070013OtherBLUE CROSS BLUE SHIELD
KY086870700OtherBLACK LUNG
KY55034029Medicaid
WI82611300Medicaid