Provider Demographics
NPI:1629197959
Name:CITY OF LINDSBORG
Entity Type:Organization
Organization Name:CITY OF LINDSBORG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DARYL
Authorized Official - Middle Name:R
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-227-2988
Mailing Address - Street 1:PO BOX 70
Mailing Address - Street 2:
Mailing Address - City:LINDSBORG
Mailing Address - State:KS
Mailing Address - Zip Code:67456-0070
Mailing Address - Country:US
Mailing Address - Phone:785-227-2988
Mailing Address - Fax:785-227-9955
Practice Address - Street 1:102 S 1ST ST
Practice Address - Street 2:
Practice Address - City:LINDSBORG
Practice Address - State:KS
Practice Address - Zip Code:67456-2402
Practice Address - Country:US
Practice Address - Phone:785-227-2988
Practice Address - Fax:785-227-9955
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY OF LINDSBORG
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-28
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS10903416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100091840AMedicaid
KS100091840AMedicaid