Organization
COFFEYVILLE REGIONAL MEDICAL CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN LAWRENCE (CEO)
(620) 251-1200
Entity
Organization
Contact information
Practice address
1400 W 4TH STREET, COFFEYVILLE, KS 67337
(620) 251-1200
(620) 252-1562
Mailing address
1400 W 4TH STREET, COFFEYVILLE, KS 67337-3306
(620) 251-1200
(620) 252-1562
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
400
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005571
BCBS
KS
05
—
100107200G
—
KS
05
—
100695360B
—
OK
Enumeration date
01/09/2007
Last updated
03/17/2023
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