Provider Demographics
NPI:1063948354
Name:INFINITY TRANSPORTATON
Entity type:Organization
Organization Name:INFINITY TRANSPORTATON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:IYSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-973-2783
Mailing Address - Street 1:1448 N GLENWOOD ST APT 2E
Mailing Address - Street 2:
Mailing Address - City:GRIFFITH
Mailing Address - State:IN
Mailing Address - Zip Code:46319-1925
Mailing Address - Country:US
Mailing Address - Phone:708-973-2783
Mailing Address - Fax:
Practice Address - Street 1:1448 N GLENWOOD ST APT 2E
Practice Address - Street 2:
Practice Address - City:GRIFFITH
Practice Address - State:IN
Practice Address - Zip Code:46319-1925
Practice Address - Country:US
Practice Address - Phone:708-973-2783
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-04
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)