Healthcare Provider Details

I. General information

NPI: 1053145292
Provider Name (Legal Business Name): IKON TRANSPORT OF INDIANA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2024
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9855 CROSSPOINT BLVD STE 134
INDIANAPOLIS IN
46256-3353
US

IV. Provider business mailing address

1 PARKER PL STE 750
JANESVILLE WI
53545-4080
US

V. Phone/Fax

Practice location:
  • Phone: 317-907-1700
  • Fax:
Mailing address:
  • Phone: 608-314-2743
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: PAUL SANDOR
Title or Position: PRESIDENT
Credential:
Phone: 317-907-1700