Provider Demographics
NPI:1467569582
Name:CITY OF LAWRENCEBURG
Entity Type:Organization
Organization Name:CITY OF LAWRENCEBURG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BOBBY
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-537-4144
Mailing Address - Street 1:300 W TATE ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47025-1974
Mailing Address - Country:US
Mailing Address - Phone:812-537-4144
Mailing Address - Fax:812-537-2065
Practice Address - Street 1:300 WEST TATE STREET
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:IN
Practice Address - Zip Code:47025
Practice Address - Country:US
Practice Address - Phone:812-537-4144
Practice Address - Fax:812-537-2065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2017-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY55001242Medicaid
IN200331320AMedicaid
OH2266659Medicaid
IN224250Medicare PIN
IN200331320AMedicaid