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Organization
MED-A-PORT INC.
Active
Organization
MED-A-PORT INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NATHAN SANDERS (CEO)
(765) 807-5041
Entity
Organization
Contact information
Practice address
1025 S 26TH ST, LAFAYETTE, IN 47905-1641
(765) 807-5041
(765) 807-0745
Mailing address
1025 S 26TH ST, LAFAYETTE, IN 47905-1641
(765) 807-5041
(765) 807-0745
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
83103ETA
IN
Other
Enumeration date
12/22/2010
Last updated
12/22/2010
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