Provider Demographics
NPI:1154582229
Name:ANDCO MEDICAL TRANSPORTATION, INC
Entity type:Organization
Organization Name:ANDCO MEDICAL TRANSPORTATION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MADALYN
Authorized Official - Middle Name:K
Authorized Official - Last Name:EAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-275-6107
Mailing Address - Street 1:1231 OAK MNR
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:IN
Mailing Address - Zip Code:47421-2736
Mailing Address - Country:US
Mailing Address - Phone:812-275-6107
Mailing Address - Fax:812-275-6107
Practice Address - Street 1:1231 OAK MNR
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:IN
Practice Address - Zip Code:47421-2736
Practice Address - Country:US
Practice Address - Phone:812-275-6107
Practice Address - Fax:812-275-6107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-21
Last Update Date:2008-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INDLN8946656523347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle