Provider Demographics
NPI:1205385770
Name:BLACK CAB TAXI & SHUTTLE, INC
Entity Type:Organization
Organization Name:BLACK CAB TAXI & SHUTTLE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:B
Authorized Official - Last Name:VESTAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-603-1362
Mailing Address - Street 1:PO BOX 1183
Mailing Address - Street 2:
Mailing Address - City:MCHENRY
Mailing Address - State:IL
Mailing Address - Zip Code:60051-9019
Mailing Address - Country:US
Mailing Address - Phone:815-363-8294
Mailing Address - Fax:815-363-1633
Practice Address - Street 1:500 CARTWRIGHT TRL
Practice Address - Street 2:
Practice Address - City:MCHENRY
Practice Address - State:IL
Practice Address - Zip Code:60050-5978
Practice Address - Country:US
Practice Address - Phone:815-363-8294
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-26
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)