1972949113 NPI number — LAWRENCE MEMORIAL HOSPITAL

Table of content: (NPI 1972949113)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972949113 NPI number — LAWRENCE MEMORIAL HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LAWRENCE MEMORIAL HOSPITAL
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:
TOTAL FAMILY CARE
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:
1972949113
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/01/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1130 W 4TH ST
Provider Second Line Business Mailing Address:
SUITE 3322
Provider Business Mailing Address City Name:
LAWRENCE
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66044-1328
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
785-505-5850
Provider Business Mailing Address Fax Number:
785-505-3322

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
346 MAINE ST
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
LAWRENCE
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66044-1393
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-840-0505
Provider Business Practice Location Address Fax Number:
785-840-9014
Provider Enumeration Date:
05/15/2013

Additional Information

Authorized Official

Authorized Official Last Name:
MILLER
Authorized Official First Name:
AMY
Authorized Official Middle Name:
C
Authorized Official Title or Position:
CRED SPEC
Authorized Official Telephone Number:
785-505-2988

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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