Provider Demographics
NPI:1952812307
Name:AVON TRUST CARE, INC.
Entity Type:Organization
Organization Name:AVON TRUST CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HUMPHREY
Authorized Official - Middle Name:
Authorized Official - Last Name:EBEA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-701-7860
Mailing Address - Street 1:10608 CYRUS DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46231-1023
Mailing Address - Country:US
Mailing Address - Phone:317-701-7860
Mailing Address - Fax:
Practice Address - Street 1:10608 CYRUS DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46231-1023
Practice Address - Country:US
Practice Address - Phone:317-701-7860
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-12
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)