Provider Demographics
NPI:1871045237
Name:HERE 2 THERE & BACK
Entity Type:Organization
Organization Name:HERE 2 THERE & BACK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:VASHAUN
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:317-250-2068
Mailing Address - Street 1:3420 WATERLOO DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-4822
Mailing Address - Country:US
Mailing Address - Phone:317-250-2068
Mailing Address - Fax:317-291-0423
Practice Address - Street 1:3420 WATERLOO DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-4822
Practice Address - Country:US
Practice Address - Phone:317-250-2068
Practice Address - Fax:317-291-0423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-01
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN0290023440343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)