Provider Demographics
NPI:1225593387
Name:TAPER, INDIA
Entity Type:Individual
Prefix:
First Name:INDIA
Middle Name:
Last Name:TAPER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19401 CHRISTANNA HWY
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23868-2612
Mailing Address - Country:US
Mailing Address - Phone:434-378-6518
Mailing Address - Fax:
Practice Address - Street 1:19401 CHRISTANNA HWY
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:VA
Practice Address - Zip Code:23868-2612
Practice Address - Country:US
Practice Address - Phone:434-378-6518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-04
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA832252399Medicaid