Healthcare Provider Details

I. General information

NPI: 1285661223
Provider Name (Legal Business Name): CITY OF NORWICH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 09/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

226 MAIN ST
NORWICH KS
67118
US

IV. Provider business mailing address

226 MAIN ST
NORWICH KS
67118
US

V. Phone/Fax

Practice location:
  • Phone: 620-478-2221
  • Fax: 620-478-2139
Mailing address:
  • Phone: 620-478-2221
  • Fax: 620-478-2139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146M00000X
TaxonomyIntermediate Emergency Medical Technician
License Number1460
License Number StateKS

VIII. Authorized Official

Name: JAN W. SMITH
Title or Position: DIRECTOR
Credential:
Phone: 620-478-2221