Provider Demographics
NPI:1801000575
Name:HARRODSBURG TRANSPORTATION COMPANY, INC
Entity Type:Organization
Organization Name:HARRODSBURG TRANSPORTATION COMPANY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ALVIS
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-734-9944
Mailing Address - Street 1:749 NORTH COLLEGE STREET
Mailing Address - Street 2:SUITE A
Mailing Address - City:HARRODSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40330
Mailing Address - Country:US
Mailing Address - Phone:859-734-9944
Mailing Address - Fax:859-734-9994
Practice Address - Street 1:749 NORTH COLLEGE STREET
Practice Address - Street 2:SUITE A
Practice Address - City:HARRODSBURG
Practice Address - State:KY
Practice Address - Zip Code:40330
Practice Address - Country:US
Practice Address - Phone:859-734-9944
Practice Address - Fax:859-734-9994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY60-134343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100003150Medicaid
KY7100003140Medicaid
KY7100006170Medicaid