Provider Demographics
NPI:1407048218
Name:PYRAMID EXPRESS SHUTTLE
Entity Type:Organization
Organization Name:PYRAMID EXPRESS SHUTTLE
Other - Org Name:LONNIE S HITE WATTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROPREITOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LONNIE
Authorized Official - Middle Name:S
Authorized Official - Last Name:HITE WATTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-591-1829
Mailing Address - Street 1:3762 N EMERSON AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46218-1738
Mailing Address - Country:US
Mailing Address - Phone:317-591-1829
Mailing Address - Fax:317-541-9681
Practice Address - Street 1:3762 N EMERSON AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46218-1738
Practice Address - Country:US
Practice Address - Phone:317-591-1829
Practice Address - Fax:317-541-9681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INUSDOT 1495699343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)