Healthcare Provider Details

I. General information

NPI: 1407080013
Provider Name (Legal Business Name): A TOP DOG TRANSPORT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2009
Last Update Date: 07/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 S BLOOMINGTON ST
GREENCASTLE IN
46135-2208
US

IV. Provider business mailing address

1300 S BLOOMINGTON ST
GREENCASTLE IN
46135-2208
US

V. Phone/Fax

Practice location:
  • Phone: 317-989-6666
  • Fax:
Mailing address:
  • Phone: 317-989-6666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number0981
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: CAROL L ANDERSON
Title or Position: PRESIDENT
Credential:
Phone: 317-989-6666