Healthcare Provider Details

I. General information

NPI: 1285701292
Provider Name (Legal Business Name): CITY OF LAFAYETTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 07/08/2024
Certification Date: 07/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 NORTH 111TH STREET
LAFAYETTE CO
80026-0068
US

IV. Provider business mailing address

PO BOX 9150
PADUCAH KY
42002-9150
US

V. Phone/Fax

Practice location:
  • Phone: 303-665-9661
  • Fax: 303-604-3862
Mailing address:
  • Phone: 270-744-9600
  • Fax: 270-744-8642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MANDY STALEY
Title or Position: ACCOUNTANT
Credential:
Phone: 303-661-1246