MEDICARE: CITY OF LAWRENCE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance	995	KS

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	590010886	OTHER	KS	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	119992	OTHER	KS	BC BS OF KANSAS

General Provider Information

NPI Number	:	1437153038
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF LAWRENCE

Provider Business Mailing Address
First Line	:	1911 STEWART AVE
Second Line	:
City	:	LAWRENCE
State	:	KS
Zip	:	66046-2516
Country	:	US
Telephone Number	:	785-830-7000
Fax Number	:	785-830-7090

Provider Business Practice Location Address
First Line	:	1911 STEWART AVE
Second Line	:
City	:	LAWRENCE
State	:	KS
Zip	:	66046
Country	:	US
Telephone Number	:	785-830-7000
Fax Number	:	785-830-7090

Authorized Official
Title or Position	:	INTERIM FIRE CHIEF
Name	:	MR. SHAUN D COFFEY
Credential	:
Telephone Number	:	785-830-7000

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	06/04/2020

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Directions to “CITY OF LAWRENCE ” Practice Location

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