Provider Demographics
NPI:1750332706
Name:CITY OF SOMERSET
Entity Type:Organization
Organization Name:CITY OF SOMERSET
Other - Org Name:SOMERSET FIRE EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:LATHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-679-6388
Mailing Address - Street 1:PO BOX 3348
Mailing Address - Street 2:
Mailing Address - City:WEST SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42564-3348
Mailing Address - Country:US
Mailing Address - Phone:606-679-6388
Mailing Address - Fax:606-677-9855
Practice Address - Street 1:301 HAIL KNOB RD
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-3410
Practice Address - Country:US
Practice Address - Phone:606-679-6388
Practice Address - Fax:606-677-9855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-15
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1324341600000X, 3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1115609OtherPASSPORT
KY56004724Medicaid
KY55100044Medicaid
KY56004724Medicaid