Provider Demographics
NPI:1285661223
Name:CITY OF NORWICH
Entity Type:Organization
Organization Name:CITY OF NORWICH
Other - Org Name:CITY OF NORWICH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAN
Authorized Official - Middle Name:W
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-478-2221
Mailing Address - Street 1:226 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:KS
Mailing Address - Zip Code:67118
Mailing Address - Country:US
Mailing Address - Phone:620-478-2221
Mailing Address - Fax:620-478-2139
Practice Address - Street 1:226 MAIN ST
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:KS
Practice Address - Zip Code:67118
Practice Address - Country:US
Practice Address - Phone:620-478-2221
Practice Address - Fax:620-478-2139
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY OF NORWICH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-26
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1460146M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, IntermediateGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100243010AMedicaid
KS100243010AMedicaid