1386942639 NPI number — CITY OF LAFAYETTE

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386942639 NPI number — CITY OF LAFAYETTE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF LAFAYETTE
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:
Provider Other Organization Name Type Code:
6
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:
1386942639
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/10/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
700 9TH ST.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAFAYETTE
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
56054
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
507-228-8241
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 MAIN AVE.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAFAYETTE
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56054
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
507-228-8015
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/10/2011

Additional Information

Authorized Official

Authorized Official Last Name:
SAFFERT
Authorized Official First Name:
DARREN
Authorized Official Middle Name:
DENNIS
Authorized Official Title or Position:
COUNCILMAN
Authorized Official Telephone Number:
507-228-8754

Provider Taxonomy Codes

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

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





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