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General NPI Number Information
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NPI Number | 1982851713
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Entity Type | Organization
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Legal Business Name | HOOSIER TRANSPORT SERVICE INC
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Dates
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Enumeration Date | 08/22/2008
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Last Update Date | 08/22/2008
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Provider Practice Location Address
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Address Line | 101 CONNIE AVE
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City | SALEM
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State | IN
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Zip | 47167-2305
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Country | US
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Telephone | 812-883-9256
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Fax | 812-883-9204
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Provider Business Mailing Address
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Address Line | 221 HICKORY AVE
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City | SALEM
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State | IN
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Zip | 47167-7944
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Country | US
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Telephone | 812-883-9341
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Fax |
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Authorized Official
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Title or Position | OWNER/ PRESIDENT
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Name | MR. BRIAN SCOTT HEDRICK
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Credential |
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Telephone | 812-883-9256
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | 68493
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License Number State | IN
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