Provider Demographics
NPI:1871593608
Name:WAYNE COUNTY FISCAL COURT
Entity type:Organization
Organization Name:WAYNE COUNTY FISCAL COURT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:SHERWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CORDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-348-3301
Mailing Address - Street 1:836 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-1407
Mailing Address - Country:US
Mailing Address - Phone:800-676-4785
Mailing Address - Fax:304-522-4222
Practice Address - Street 1:111 JIM HILL SERVICE RD
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:KY
Practice Address - Zip Code:42633-7901
Practice Address - Country:US
Practice Address - Phone:606-348-3301
Practice Address - Fax:606-348-3304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-22
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA16483416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP00300479OtherRAILROAD MEDICARE
KY000000328512OtherANTHEM
TN4287026Medicaid
KY56026529Medicaid
KY2626308000OtherPASSPORT ADVANTAGE
KY610617500OtherBLACK LUNG
OH2502518Medicaid
KY50008672OtherPASSPORT
KY55000970Medicaid
KY610617500OtherBLACK LUNG
KY=========OtherTRICARE
KY55000970Medicaid