Provider Demographics
NPI:1609063536
Name:AMERICARE MEDICAL TRANSPORT LLC
Entity Type:Organization
Organization Name:AMERICARE MEDICAL TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:A
Authorized Official - Last Name:OTT
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:317-984-4100
Mailing Address - Street 1:110 W. JACKSON ST.
Mailing Address - Street 2:
Mailing Address - City:CICERO
Mailing Address - State:IN
Mailing Address - Zip Code:46034-9261
Mailing Address - Country:US
Mailing Address - Phone:317-984-4100
Mailing Address - Fax:317-984-4111
Practice Address - Street 1:3535 CROUCH ST
Practice Address - Street 2:UNIT A
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-0748
Practice Address - Country:US
Practice Address - Phone:765-449-7100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN64519343800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)