Daniel O Biokoro

Individual provider Active NPI Driver · Crown Point, IN

NPI 1265046221 · NPPES record last updated Sep 7, 2020

Key facts

NPI
1265046221
Entity type
Individual (NPI type 1)
Primary specialty
Driver 172A00000X
License
5360099694 (IN)
Practice address
1446 W 94TH CT
Crown Point, IN 46307-2217
Phone
(219) 779-1280
NPI assigned
Sep 6, 2020
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
5360099694INMDDriver

Practice roles

OrganizationSpecialtyStatusNew patients
Fed LLC Current
since Sep 13, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X 67031420A
Driver 172A00000X 5360099694 IN Yes

Addresses

Primary practice location

1446 W 94TH CT
Crown Point, IN 46307-2217

Mailing address

1446 W 94TH CT
Crown Point, IN 46307-2217
Phone (219) 779-1280

Other providers in Crown Point, IN

All providers in Crown Point, IN · Driver in Indiana

Sources for this page

Verify at the official NPI Registry.