MEDICARE: IMPRESSIVE TRANSPORT SERVICES LLC

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	347E00000X	Transportation Broker

General Provider Information

NPI Number	:	1972100790
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IMPRESSIVE TRANSPORT SERVICES LLC

Provider Business Mailing Address
First Line	:	2510 RIVER ALDER WAY APT 1417
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46268-7771
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2510 RIVER ALDER WAY APT 1417
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46268-7771
Country	:	US
Telephone Number	:	512-938-9622
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ABIOLA ALAGBADA
Credential	:
Telephone Number	:	512-938-9622

Provider Enumeration Date	:	10/05/2020
Last Update Date	:	10/05/2020

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Directions to “IMPRESSIVE TRANSPORT SERVICES LLC ” Practice Location

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