Provider Demographics
NPI:1720115298
Name:ALLEN COUNTY COUNTY TREASURER
Entity Type:Organization
Organization Name:ALLEN COUNTY COUNTY TREASURER
Other - Org Name:ALLEN COUNTY AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ED
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-237-4938
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:270-237-5973
Practice Address - Street 1:100 LEX CARTER CIR
Practice Address - Street 2:
Practice Address - City:SCOTTSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42164-7604
Practice Address - Country:US
Practice Address - Phone:270-237-4938
Practice Address - Fax:270-237-5973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0014143416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY56003361Medicaid
KY590013366OtherRAILROAD MEDICARE
KY1720115298OtherWELLCARE - MEDICAID MCO
KY1720115298OtherCOVENTRY CARE - MEDICAID MCO
KY000000640246OtherANTHEM / BCBS
KY55002034Medicaid
KY590013366OtherRAILROAD MEDICARE