CMS-1500 Box 24J / 33a • NPI
1245637255
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
3416L0300X (CMS 59)
Licensed Emergency Medical Services (EMS) — BLS/ALS Ground & Air Ambulance
Box 32 Service Location & ZIP+4
440 HIGHWAY 1812 NORTH, JACKSON, KY, 41339
Official NPPES Practice Location
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1245637255 (BREATHITT COUNTY AMBULANCE, INC.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1245637255 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | BREATHITT COUNTY AMBULANCE, INC. |
| Plain-English Specialty | Licensed Emergency Medical Services (EMS) — BLS/ALS Ground & Air Ambulance NUCC Code: 3416L0300X (Ambulance, Land Transport) |
| Certifying / Licensing Body | State EMS Authority / National Registry of Emergency Medical Technicians (NREMT) |
| Practice Location Address | 440 HIGHWAY 1812 NORTH, JACKSON, KY, 41339 |
| Practice Telephone / Fax | Tel: (606) 666-8911 | Fax: (606) 666-7922 |
| Administrative Mailing Address | PO BOX 170, JACKSON, KY, 41339-0170 |
| Enumeration & Last Sync | Enumerated: 2014-11-20 | CMS Record Updated: 2014-11-20 |
| Authorized Official | DANNY MCINTOSH (President) |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (3416L0300X)
What Does Taxonomy Code 3416L0300X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 3416L0300X translates to:
"Licensed Emergency Medical Services (EMS) — BLS/ALS Ground & Air Ambulance"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (BREATHITT COUNTY AMBULANCE, INC.)
Typical CPT / Diagnostic Procedures:- Advanced Life Support (ALS) Pre-Hospital Cardiac Monitoring & Defibrillation
- Pre-Hospital Trauma Immobilization, Airway Management & IV Access
- Pre-Hospital Epinephrine, Aspirin, Nitroglycerin, Naloxone & Albuterol
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
3416L0300X — Ambulance, Land TransportPlain English: Licensed Emergency Medical Services (EMS) — BLS/ALS Ground & Air Ambulance | State: KY | License: 1649 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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