Provider Demographics
NPI:1376964254
Name:INDY AIRPORT TAXI INC
Entity Type:Organization
Organization Name:INDY AIRPORT TAXI INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MEKONNEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GEREZGHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-381-1111
Mailing Address - Street 1:4849 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46241-2223
Mailing Address - Country:US
Mailing Address - Phone:317-381-1111
Mailing Address - Fax:317-381-0866
Practice Address - Street 1:4849 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46241-2223
Practice Address - Country:US
Practice Address - Phone:317-381-1111
Practice Address - Fax:317-381-0866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-19
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)