Provider Demographics
NPI:1588679328
Name:CITY OF LARNED
Entity Type:Organization
Organization Name:CITY OF LARNED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:HARTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:EMT
Authorized Official - Phone:620-285-8505
Mailing Address - Street 1:123 W 9TH ST
Mailing Address - Street 2:
Mailing Address - City:LARNED
Mailing Address - State:KS
Mailing Address - Zip Code:67550-2510
Mailing Address - Country:US
Mailing Address - Phone:620-285-8505
Mailing Address - Fax:620-285-8507
Practice Address - Street 1:123 W 9TH ST
Practice Address - Street 2:
Practice Address - City:LARNED
Practice Address - State:KS
Practice Address - Zip Code:67550-2510
Practice Address - Country:US
Practice Address - Phone:620-285-8505
Practice Address - Fax:620-285-8507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS9903416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100091870AMedicaid
KS100091870AMedicaid
KS005689Medicare ID - Type UnspecifiedMEDICARE