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General NPI Number Information
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NPI Number | 1538546742
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Entity Type | Organization
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Legal Business Name | SORGI SPORTS LLC
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Dates
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Enumeration Date | 04/27/2015
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Last Update Date | 12/01/2017
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Provider Practice Location Address
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Address Line | 1531 E. NORTHFIELD DR. SUITE 300
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City | BROWNSBURG
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State | IN
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Zip | 46112
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Country | US
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Telephone | 317-892-8180
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Fax | 317-534-3440
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Provider Business Mailing Address
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Address Line | 1531 E. NORTHFIELD DR. SUITE #300
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City | BROWNSBURG
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State | IN
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Zip | 46112
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Country | US
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Telephone | 317-892-8180
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Fax | 317-534-3440
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MRS. KIMBERLY ANN MYERS
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Credential |
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Telephone | 317-892-8180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State | IN
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