Provider Demographics
NPI:1548291933
Name:CITY OF LANSING
Entity type:Organization
Organization Name:CITY OF LANSING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EMS CAPTAIN
Authorized Official - Prefix:
Authorized Official - First Name:LOY
Authorized Official - Middle Name:G
Authorized Official - Last Name:LACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-896-9090
Mailing Address - Street 1:PO BOX 674091
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48267-0001
Mailing Address - Country:US
Mailing Address - Phone:517-485-0001
Mailing Address - Fax:
Practice Address - Street 1:120 E SHIAWASSEE ST
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48933-1219
Practice Address - Country:US
Practice Address - Phone:517-483-4563
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3310033416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
590009545OtherRAILROAD MEDICARE
MI200000000497OtherPHP
MI590C30149OtherBLUE CROSS BLUE SHIELD
MI2829235Medicaid
MI2829235Medicaid