MEDICARE: INDIANA STS SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1598915324
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INDIANA STS SERVICES INC

Provider Business Mailing Address
First Line	:	7002 GRAHAM RD
Second Line	:	SUITE 103
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-4057
Country	:	US
Telephone Number	:	317-614-0929
Fax Number	:	317-245-9340

Provider Business Practice Location Address
First Line	:	7002 GRAHAM RD
Second Line	:	SUITE 103
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-4057
Country	:	US
Telephone Number	:	317-614-0929
Fax Number	:	317-245-9340

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JUAN A CASTRO RODON
Credential	:
Telephone Number	:	317-614-0929

Provider Enumeration Date	:	09/29/2008
Last Update Date	:	09/29/2008

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