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General NPI Number Information
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NPI Number | 1144461666
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Entity Type | Organization
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Legal Business Name | ZOOM TRANSPORT SERVICE
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Dates
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Enumeration Date | 03/12/2009
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Last Update Date | 03/12/2009
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Provider Practice Location Address
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Address Line | 1425 CARROLLTON AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46202-2714
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Country | US
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Telephone | 317-710-3219
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Fax |
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Provider Business Mailing Address
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Address Line | 1425 CARROLLTON AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46202-2714
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Country | US
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Telephone | 317-710-3219
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | CHARLES KENNEDY JR.
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Credential |
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Telephone | 317-710-3219
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347E00000X
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Taxonomy Name | Transportation Broker
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License Number |
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State | IN
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