Provider Demographics
NPI:1518959246
Name:GARDNER ENTERPRISES
Entity Type:Organization
Organization Name:GARDNER ENTERPRISES
Other - Org Name:NICHOLAS COUNTY EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHASITY
Authorized Official - Middle Name:
Authorized Official - Last Name:GARDNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-289-5522
Mailing Address - Street 1:368 1/2 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:KY
Mailing Address - Zip Code:40311-1158
Mailing Address - Country:US
Mailing Address - Phone:859-289-5522
Mailing Address - Fax:
Practice Address - Street 1:836 4TH AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-1407
Practice Address - Country:US
Practice Address - Phone:800-676-4785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY12713416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY8054501Medicare ID - Type Unspecified