Provider Demographics
NPI:1689672586
Name:BROWN AMBULANCE SERVICE INC
Entity Type:Organization
Organization Name:BROWN AMBULANCE SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JONI
Authorized Official - Middle Name:
Authorized Official - Last Name:DOUGLAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-235-0622
Mailing Address - Street 1:PO BOX 589
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42431-5011
Mailing Address - Country:US
Mailing Address - Phone:270-824-8123
Mailing Address - Fax:270-824-8140
Practice Address - Street 1:101 ROGERS PARK
Practice Address - Street 2:SUITE 1
Practice Address - City:CYNTHIANA
Practice Address - State:KY
Practice Address - Zip Code:41031-1242
Practice Address - Country:US
Practice Address - Phone:859-234-1515
Practice Address - Fax:859-234-1566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-13
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000014500OtherCHA
KY55049019Medicaid
KY590015159OtherRAILROAD MEDICARE
97349OtherCOVENTRY - MEDICAID MCO
KY1083653OtherPASSPORT
KY000000074795OtherANTHEM
163165900OtherFEDERAL BLACK LUNG
KY243562100OtherPASSPORT ADVANTAGE
KY56003577Medicaid
KY=========OtherUMWA
KY56003577Medicaid
KY55049019Medicaid
KY000000074795OtherANTHEM