Provider Demographics
NPI:1154372779
Name:ASAP
Entity type:Organization
Organization Name:ASAP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:FLORA
Authorized Official - Middle Name:M
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-546-2727
Mailing Address - Street 1:3876 N SHERIDAN AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46226-4987
Mailing Address - Country:US
Mailing Address - Phone:317-546-2727
Mailing Address - Fax:317-546-2700
Practice Address - Street 1:3876 N SHERIDAN AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46226-4987
Practice Address - Country:US
Practice Address - Phone:317-546-2727
Practice Address - Fax:317-546-2700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200804650AMedicaid
IN200804650AMedicaid