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General NPI Number Information
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NPI Number | 1205208337
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Entity Type | Organization
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Legal Business Name | PAN-AGIS INC
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Dates
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Enumeration Date | 10/28/2015
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Last Update Date | 10/28/2015
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Provider Practice Location Address
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Address Line | 3503 W 76TH LN
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City | MERRILLVILLE
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State | IN
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Zip | 46410-4323
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Country | US
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Telephone | 219-323-5386
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Fax | 219-769-9154
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Provider Business Mailing Address
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Address Line | 3503 W 76TH LN
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City | MERRILLVILLE
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State | IN
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Zip | 46410-4323
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Country | US
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Telephone | 219-323-5386
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Fax | 219-769-9154
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHELLE N PANAYI
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Credential |
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Telephone | 219-323-5386
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number | 8911669519
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License Number State | IN
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