Provider Demographics
NPI:1598764334
Name:CENTRAL CAMPBELL COUNTY FIRE DISTRICT
Entity Type:Organization
Organization Name:CENTRAL CAMPBELL COUNTY FIRE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:SCHULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-441-7631
Mailing Address - Street 1:PO BOX 392907
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15251
Mailing Address - Country:US
Mailing Address - Phone:800-962-1484
Mailing Address - Fax:513-772-4464
Practice Address - Street 1:4113 ALEXANDRIA PIKE
Practice Address - Street 2:
Practice Address - City:COLD SPRING
Practice Address - State:KY
Practice Address - Zip Code:41076-1819
Practice Address - Country:US
Practice Address - Phone:859-441-7631
Practice Address - Fax:859-781-5115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-14
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1560341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2369182Medicaid
KY56019128Medicaid
KY590014761OtherRAILROAD MEDICARE
KY000000216161OtherANTHEM
KY55000400Medicaid
KY080648900OtherBLACK LUNG
KYCHOICE CARE C3569OtherCHOICE CARE
OH2369182Medicaid