Healthcare Provider Details

I. General information

NPI: 1548291933
Provider Name (Legal Business Name): CITY OF LANSING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 05/15/2024
Certification Date: 05/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 E SHIAWASSEE ST
LANSING MI
48933-1219
US

IV. Provider business mailing address

PO BOX 674091
DETROIT MI
48267-0001
US

V. Phone/Fax

Practice location:
  • Phone: 517-483-4563
  • Fax:
Mailing address:
  • Phone: 517-485-0001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number331003
License Number StateMI

VIII. Authorized Official

Name: LOY G LACK
Title or Position: EMS CAPTAIN
Credential:
Phone: 517-896-9090