Provider Demographics
NPI:1780068122
Name:KOSCIUSKO AMBULANCE SERVICES LLC
Entity type:Organization
Organization Name:KOSCIUSKO AMBULANCE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP PHYSICIAN BUSINESS SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:P
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-778-1502
Mailing Address - Street 1:PO BOX 689022
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37068-9022
Mailing Address - Country:US
Mailing Address - Phone:615-465-7000
Mailing Address - Fax:615-628-6877
Practice Address - Street 1:34 E ARMSTRONG RD
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:IN
Practice Address - Zip Code:46538-9368
Practice Address - Country:US
Practice Address - Phone:574-269-1975
Practice Address - Fax:574-453-4276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-15
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance