Provider Demographics
NPI:1427358811
Name:I TRANSPORT NEMT
Entity Type:Organization
Organization Name:I TRANSPORT NEMT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TOBY
Authorized Official - Middle Name:A
Authorized Official - Last Name:DAVIDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-406-6041
Mailing Address - Street 1:2410 WOOD DUCK PL
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-7480
Mailing Address - Country:US
Mailing Address - Phone:812-406-6041
Mailing Address - Fax:
Practice Address - Street 1:2410 WOOD DUCK PL
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-7480
Practice Address - Country:US
Practice Address - Phone:812-406-6041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-01
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1760-04-2035343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)