Provider Demographics
NPI:1114600517
Name:VITAL SHUTTLE LLC
Entity Type:Organization
Organization Name:VITAL SHUTTLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-498-6845
Mailing Address - Street 1:2850 W SEIPP ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60652-3840
Mailing Address - Country:US
Mailing Address - Phone:312-498-6845
Mailing Address - Fax:312-275-8154
Practice Address - Street 1:2850 W SEIPP ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60652-3840
Practice Address - Country:US
Practice Address - Phone:312-498-6845
Practice Address - Fax:312-275-8154
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TANOM & GREER LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-11
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)