Provider Demographics
NPI:1922083021
Name:MORGAN COUNTY AMBULANCE TAXING DISTRICT
Entity Type:Organization
Organization Name:MORGAN COUNTY AMBULANCE TAXING DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FLORA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOCKERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-743-7490
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 1:412 DOGWOOD LN
Practice Address - Street 2:
Practice Address - City:WEST LIBERTY
Practice Address - State:KY
Practice Address - Zip Code:41472-1259
Practice Address - Country:US
Practice Address - Phone:606-743-7490
Practice Address - Fax:606-743-2700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-12
Last Update Date:2018-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY11673416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
361683100OtherFEDERAL BLACK LUNG PROGRAM
KY55088033Medicaid
KY000000070097OtherANTHEM BLUE CROSS
KY56004450Medicaid
KY56004450Medicaid
590004335Medicare PIN