Provider Demographics
NPI:1417145244
Name:TRANSPORTATION EXPRESS SHUTTLE
Entity Type:Organization
Organization Name:TRANSPORTATION EXPRESS SHUTTLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:MCMULLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-249-4768
Mailing Address - Street 1:104 N 7TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635
Mailing Address - Country:US
Mailing Address - Phone:520-249-4768
Mailing Address - Fax:520-803-0148
Practice Address - Street 1:104 N 7TH ST # THSTA
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-1900
Practice Address - Country:US
Practice Address - Phone:520-249-4768
Practice Address - Fax:520-803-0148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-05
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0700002346344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi