Provider Demographics
NPI:1629095385
Name:PARIS-BOURBON COUNTY EMS
Entity Type:Organization
Organization Name:PARIS-BOURBON COUNTY EMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS MAJOR
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:PROFFITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-987-2154
Mailing Address - Street 1:PO BOX 228
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:KY
Mailing Address - Zip Code:40362
Mailing Address - Country:US
Mailing Address - Phone:859-987-2110
Mailing Address - Fax:859-987-4640
Practice Address - Street 1:313 HIGH ST
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:KY
Practice Address - Zip Code:40361
Practice Address - Country:US
Practice Address - Phone:859-987-2110
Practice Address - Fax:859-987-4640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY14173416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY55009047Medicaid
KY50004380Medicaid
KY080015100OtherBLACK LUNG
KY56004617Medicaid
KY000000070115OtherBLUE CROSS BLUE SHIELD
KY2445745000OtherPASSPORT ADVANTAGE
KY50004380Medicaid
KY8019501Medicare PIN