Provider Demographics
NPI:1649411083
Name:HABERMEHL MEDICAL TRANSPORT
Entity Type:Organization
Organization Name:HABERMEHL MEDICAL TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HABERMEHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-670-6083
Mailing Address - Street 1:404 FLOWERY BRANCH CT
Mailing Address - Street 2:
Mailing Address - City:VILLA RICA
Mailing Address - State:GA
Mailing Address - Zip Code:30180-5548
Mailing Address - Country:US
Mailing Address - Phone:317-670-6083
Mailing Address - Fax:317-421-0473
Practice Address - Street 1:4303 N MORRISTOWN RD
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:IN
Practice Address - Zip Code:46176-8879
Practice Address - Country:US
Practice Address - Phone:317-670-6083
Practice Address - Fax:317-421-0473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-16
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)