Provider Demographics
NPI:1609914043
Name:MCKINNEY AREA RESCUE SQUAD INC TT
Entity Type:Organization
Organization Name:MCKINNEY AREA RESCUE SQUAD INC TT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:D
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-346-5300
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:270-744-9600
Mailing Address - Fax:270-744-0834
Practice Address - Street 1:3305 MIDDLEBURG RD
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:KY
Practice Address - Zip Code:40448-0117
Practice Address - Country:US
Practice Address - Phone:606-346-5300
Practice Address - Fax:606-346-5300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY15613416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000198881OtherANTHEM BLUE CROSS
KY56004310Medicaid
590005636OtherRAILROAD MEDICARE
KY55069066Medicaid
8035105Medicare PIN