Petersburg Fire Protection District
Organization Active NPI Land Ambulance · Petersburg, KY
NPI 1104825595 · NPPES record last updated Jun 2, 2026
Key facts
- NPI
- 1104825595
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- 1581 (KY)
- Legal business name
- PETERSBURG FIRE PROTECTION DISTRICT
- Practice address
- 2018 2ND St.
Petersburg, KY 41080-0068 - Phone
- (859) 586-4688
- NPI assigned
- Jul 18, 2005
- Organization subpart
- No
Authorized official
- Name
- Brian Luther Hall
- Title
- Fire Chief
- Phone
- (859) 495-4685
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040105000856 | KY | Part B Supplier - Ambulance Service Supplier | 1052210473 | Practice locations: Petersburg, KY |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 1581 | KY | Yes |
Addresses
Primary practice location
2018 2ND St.
Petersburg, KY 41080-0068
Mailing address
836 4TH Ave
Huntington, WV 25701-1407
Phone (304) 521-1576
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 590011845 | Other | KY | RAILROAD MEDICARE |
| 000000070130 | Other | KY | ANTHEM |
| 55008098 | Medicaid | KY |
Other providers in Petersburg, KY
All providers in Petersburg, KY · Land Ambulance in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 2, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.