Provider Demographics
NPI:1104180116
Name:MIGHTY TRANSPORT LLC
Entity Type:Organization
Organization Name:MIGHTY TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:NOBACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-401-7433
Mailing Address - Street 1:2301 W MICHIGAN ST STE I
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47712-5263
Mailing Address - Country:US
Mailing Address - Phone:812-401-7433
Mailing Address - Fax:812-401-3416
Practice Address - Street 1:2301 W MICHIGAN ST STE I
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47712-5263
Practice Address - Country:US
Practice Address - Phone:812-401-7433
Practice Address - Fax:812-401-3416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-25
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)