Provider Demographics
NPI:1679539449
Name:HENRY COUNTY COUNTY TREASURER
Entity Type:Organization
Organization Name:HENRY COUNTY COUNTY TREASURER
Other - Org Name:HENRY COUNTY EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR SUPERVISOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:MCCLAMROCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-845-5400
Mailing Address - Street 1:716 S PROPERTY RD
Mailing Address - Street 2:
Mailing Address - City:EMINENCE
Mailing Address - State:KY
Mailing Address - Zip Code:40019
Mailing Address - Country:US
Mailing Address - Phone:502-845-5400
Mailing Address - Fax:502-845-5711
Practice Address - Street 1:716 S PROPERTY RD
Practice Address - Street 2:
Practice Address - City:EMINENCE
Practice Address - State:KY
Practice Address - Zip Code:40019
Practice Address - Country:US
Practice Address - Phone:502-845-5400
Practice Address - Fax:502-845-5711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-21
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY16423416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY56004104Medicaid
KY55000624Medicaid
KY000000070455OtherBLUE CROSS BLUE SHIELD
KY1066361OtherPASSPORT HEALTH
KY2434600000OtherPASSPORT ADVANTAGE
KY0037701Medicare PIN