Provider Demographics
NPI:1740479823
Name:FULTON COUNTY TRANSIT AUTHORITY
Entity type:Organization
Organization Name:FULTON COUNTY TRANSIT AUTHORITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:MAXWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-472-0662
Mailing Address - Street 1:PO BOX 1601
Mailing Address - Street 2:302 EASTWOOD DR.
Mailing Address - City:FULTON
Mailing Address - State:KY
Mailing Address - Zip Code:42041-0601
Mailing Address - Country:US
Mailing Address - Phone:270-472-0662
Mailing Address - Fax:270-472-0668
Practice Address - Street 1:302 EASTWOOD DR.
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:KY
Practice Address - Zip Code:42041-0601
Practice Address - Country:US
Practice Address - Phone:270-472-0662
Practice Address - Fax:270-472-0668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-15
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5600137300343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY56001365Medicaid
KY56000763Medicaid
KY56001373Medicaid