Provider Demographics
NPI:1497445092
Name:JETT TRANSPORTATION SERVICES LLC
Entity Type:Organization
Organization Name:JETT TRANSPORTATION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:KRISTIN
Authorized Official - Last Name:HANSON
Authorized Official - Suffix:
Authorized Official - Credentials:LALD
Authorized Official - Phone:612-499-3987
Mailing Address - Street 1:17699 311TH CT
Mailing Address - Street 2:
Mailing Address - City:SHAFER
Mailing Address - State:MN
Mailing Address - Zip Code:55074-9217
Mailing Address - Country:US
Mailing Address - Phone:612-499-3987
Mailing Address - Fax:
Practice Address - Street 1:17699 311TH CT
Practice Address - Street 2:
Practice Address - City:SHAFER
Practice Address - State:MN
Practice Address - Zip Code:55074-9217
Practice Address - Country:US
Practice Address - Phone:612-499-3987
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)