Provider Demographics
NPI:1891725768
Name:DHP INCORPORATED
Entity Type:Organization
Organization Name:DHP INCORPORATED
Other - Org Name:DHP AMBULANCE SVC MAGOFFIN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FAIRLIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-489-8446
Mailing Address - Street 1:171 ABBOTT CREEK RD STE 1
Mailing Address - Street 2:
Mailing Address - City:PRESTONSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41653-8969
Mailing Address - Country:US
Mailing Address - Phone:606-886-9845
Mailing Address - Fax:606-886-0834
Practice Address - Street 1:1060 PARKWAY DRIVE
Practice Address - Street 2:
Practice Address - City:SALYERSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41465-1060
Practice Address - Country:US
Practice Address - Phone:606-349-5555
Practice Address - Fax:606-886-0834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1670341600000X, 3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY55001432Medicaid
KY56030703Medicaid
KY8044601Medicare ID - Type Unspecified