1386677136 NPI number — CITY OF EAST LANSING

Table of content: (NPI 1386677136)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386677136 NPI number — CITY OF EAST LANSING

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF EAST LANSING
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
EAST LANSING FIRE DEPARTMENT
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386677136
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/06/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2122
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RIVERVIEW
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48193-1122
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
517-332-1956
Provider Business Mailing Address Fax Number:
517-337-1112

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1700 ABBOTT RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAST LANSING
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48823-1908
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
517-337-1731
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CARSON
Authorized Official First Name:
DAWN
Authorized Official Middle Name:
MARIE
Authorized Official Title or Position:
FIRE CHIEF
Authorized Official Telephone Number:
517-319-6972

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  331002 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2723272 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 590008650 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 200000000498 . This is a "PHPMM" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 590C302390 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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