Provider Demographics
NPI:1851448237
Name:FISCAL COURT MARSHALL COUNTY
Entity Type:Organization
Organization Name:FISCAL COURT MARSHALL COUNTY
Other - Org Name:MARSHALL COUNTY AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:CUTSINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-527-1243
Mailing Address - Street 1:PO BOX 533
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:KY
Mailing Address - Zip Code:42025-0533
Mailing Address - Country:US
Mailing Address - Phone:270-527-1243
Mailing Address - Fax:270-527-7313
Practice Address - Street 1:505 GEORGE MCCLAIN DR
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:KY
Practice Address - Zip Code:42025-1331
Practice Address - Country:US
Practice Address - Phone:270-527-1243
Practice Address - Fax:270-527-7313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY13003416L0300X, 3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY56004260Medicaid
KY55079016Medicaid
KY56004260Medicaid