Provider Demographics
NPI:1720716913
Name:SARGENT LOGISTICS
Entity type:Organization
Organization Name:SARGENT LOGISTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONTAE
Authorized Official - Middle Name:LAMAR
Authorized Official - Last Name:SARGENT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-414-9587
Mailing Address - Street 1:7515 TIMBERLANE DR
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-1811
Mailing Address - Country:US
Mailing Address - Phone:317-414-9587
Mailing Address - Fax:
Practice Address - Street 1:7515 TIMBERLANE DR
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-1811
Practice Address - Country:US
Practice Address - Phone:317-414-9587
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)