Provider Demographics
NPI:1982602306
Name:MERCER COUNTY EMERGENCY MEDICAL SERVICES, INC,
Entity type:Organization
Organization Name:MERCER COUNTY EMERGENCY MEDICAL SERVICES, INC,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:W
Authorized Official - Last Name:PARKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-734-4486
Mailing Address - Street 1:130 COMMERCIAL DR
Mailing Address - Street 2:
Mailing Address - City:HARRODSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40330-1084
Mailing Address - Country:US
Mailing Address - Phone:859-734-4486
Mailing Address - Fax:859-734-4484
Practice Address - Street 1:130 COMMERCIAL DR
Practice Address - Street 2:
Practice Address - City:HARRODSBURG
Practice Address - State:KY
Practice Address - Zip Code:40330-1084
Practice Address - Country:US
Practice Address - Phone:859-734-4486
Practice Address - Fax:859-734-4484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-09
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1365341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY55084024Medicaid
KY590011709OtherRR MEDICARE
KY56004385Medicaid
KY000000070364OtherANTHEM BCBS