Healthcare Provider Details

I. General information

NPI: 1154307650
Provider Name (Legal Business Name): CITY OF LAWRENCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2005
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9001 E 59TH ST STE 302
INDIANAPOLIS IN
46216-1036
US

IV. Provider business mailing address

PO BOX 501368
INDIANAPOLIS IN
46250-6368
US

V. Phone/Fax

Practice location:
  • Phone: 317-549-4825
  • Fax: 317-549-8671
Mailing address:
  • Phone: 317-775-6751
  • Fax: 317-498-6632

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number0196
License Number StateIN

VIII. Authorized Official

Name: ROBERT WALLACE
Title or Position: FIRE CHIEF
Credential:
Phone: 317-775-6753