Provider Demographics
NPI:1629075809
Name:MURRAY CALLOWAY COUNTY EMERGENCY
Entity Type:Organization
Organization Name:MURRAY CALLOWAY COUNTY EMERGENCY
Other - Org Name:MURRAY- CALLOWAY COUNTY EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF FINANCE/ CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-762-1104
Mailing Address - Street 1:803 POPLAR STREET
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071-2432
Mailing Address - Country:US
Mailing Address - Phone:270-762-1750
Mailing Address - Fax:270-744-8647
Practice Address - Street 1:803 POPLAR STREET
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-2432
Practice Address - Country:US
Practice Address - Phone:270-762-1750
Practice Address - Fax:270-744-8647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-04
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY10043416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
610999800OtherDEPARTMENT OF LABOR
KY55001358Medicaid
KY56029465Medicaid
LA1591645Medicaid
KY000000361285OtherANTHEM BLUE CROSS
KY000000361285OtherANTHEM BLUE CROSS
KY000000361285OtherANTHEM BLUE CROSS
LA1591645Medicaid