Organization
SUPPORT MEDICAL TRANSPORT SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS WANDA A CABELL (OWNER)
(219) 989-9135
Entity
Organization
Contact information
Practice address
7550 BERTRAM AVE, HAMMOND, IN 46324-3134
(219) 989-9135
(219) 845-5594
Mailing address
7550 BERTRAM AVE, HAMMOND, IN 46324-3134
(219) 989-9135
(219) 845-5594
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
62072
IN
Other
Enumeration date
12/29/2006
Last updated
08/22/2020
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