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General NPI Number Information
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NPI Number | 1558154609
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Entity Type | Organization
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Legal Business Name | SOVEREIGN TESTING SOLUTIONS, LLC
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Dates
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Enumeration Date | 05/22/2025
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Last Update Date | 05/22/2025
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Provider Practice Location Address
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Address Line | 1040 E 86TH ST STE 48B
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City | INDIANAPOLIS
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State | IN
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Zip | 46240-1894
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Country | US
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Telephone | 317-654-4609
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Fax |
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Provider Business Mailing Address
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Address Line | 1040 E 86TH ST STE 48B
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City | INDIANAPOLIS
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State | IN
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Zip | 46240-1894
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Country | US
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Telephone | 463-276-8533
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | NATAYA COOK
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Credential | PMP
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Telephone | 463-276-8533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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