Provider Demographics
NPI:1306379862
Name:ALLIANCE TAXI AND SHUTTLE, LLC
Entity Type:Organization
Organization Name:ALLIANCE TAXI AND SHUTTLE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:DAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-259-3111
Mailing Address - Street 1:226A SAINT JOE PLAZA DR
Mailing Address - Street 2:#144
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32164-3615
Mailing Address - Country:US
Mailing Address - Phone:386-259-3111
Mailing Address - Fax:
Practice Address - Street 1:55 BLAKEPORT LN
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-7334
Practice Address - Country:US
Practice Address - Phone:386-259-3111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-11
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi