Organization
CITY OF LAWRENCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT WALLACE (FIRE CHIEF)
(317) 775-6753
Entity
Organization
Contact information
Practice address
9001 E 59TH ST STE 302, INDIANAPOLIS, IN 46216-1036
(317) 549-4825
(317) 549-8671
Mailing address
PO BOX 501368, INDIANAPOLIS, IN 46250-6368
(317) 775-6751
(317) 498-6632
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
0196
IN
3416L0300X
Land Ambulance
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000186313
BLUE CROSS BLUE SHIELD
IN
05
—
100289300A
—
IN
01
—
590002786
RAILROAD MEDICARE
IN
Enumeration date
12/16/2005
Last updated
08/07/2025
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