Provider Demographics
NPI:1710313168
Name:SPRINTER SHUTTLE SERVICE INC
Entity Type:Organization
Organization Name:SPRINTER SHUTTLE SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:AMOS
Authorized Official - Last Name:PIENAAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-709-7889
Mailing Address - Street 1:636 BUTLER BLVD
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:OR
Mailing Address - Zip Code:97914-8610
Mailing Address - Country:US
Mailing Address - Phone:541-709-7889
Mailing Address - Fax:541-889-6661
Practice Address - Street 1:251 W IDAHO AVE # 55
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:OR
Practice Address - Zip Code:97914-2433
Practice Address - Country:US
Practice Address - Phone:541-709-7889
Practice Address - Fax:541-889-6661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-17
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID8878341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500604070Medicaid
ID808270600Medicaid