Provider Demographics
NPI:1053145292
Name:IKON TRANSPORT OF INDIANA, INC
Entity type:Organization
Organization Name:IKON TRANSPORT OF INDIANA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-504-8598
Mailing Address - Street 1:1 PARKER PL STE 750
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53545-4080
Mailing Address - Country:US
Mailing Address - Phone:608-314-2743
Mailing Address - Fax:
Practice Address - Street 1:11455 BURKWOOD DR
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46033-3991
Practice Address - Country:US
Practice Address - Phone:317-504-8598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-29
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No342000000XTransportation ServicesTransportation Network Company
No347C00000XTransportation ServicesPrivate Vehicle
No347E00000XTransportation ServicesTransportation Broker