Provider Demographics
NPI:1578704433
Name:CITY OF LAWRENCEBURG
Entity Type:Organization
Organization Name:CITY OF LAWRENCEBURG
Other - Org Name:LAWRENCEBURG EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BOBBY
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLS
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-I99
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:
Practice Address - Street 1:300 W TATE ST
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:IN
Practice Address - Zip Code:47025-1974
Practice Address - Country:US
Practice Address - Phone:812-537-4144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-23
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN03133416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200331320AMedicaid
KY55001242Medicaid
OH2266659Medicaid
224250Medicare PIN