Provider Demographics
NPI:1831157338
Name:ASSISTECH LLC
Entity type:Organization
Organization Name:ASSISTECH LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:A
Authorized Official - Last Name:WAGNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-209-1200
Mailing Address - Street 1:PO BOX 261
Mailing Address - Street 2:
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112-0261
Mailing Address - Country:US
Mailing Address - Phone:317-209-1200
Mailing Address - Fax:317-209-1206
Practice Address - Street 1:9233 E US HIGHWAY 36
Practice Address - Street 2:CHARCOAL BLDG #3
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-7929
Practice Address - Country:US
Practice Address - Phone:317-209-1200
Practice Address - Fax:317-209-1206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000384715OtherANTHEM PIN NUMBER
IN000000384715OtherANTHEM PIN NUMBER