Provider Demographics
NPI:1851608723
Name:FRIENDLY SHUTTLE & DELIVERY INC.
Entity Type:Organization
Organization Name:FRIENDLY SHUTTLE & DELIVERY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:O'CONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-978-2115
Mailing Address - Street 1:12158 197TH CT NW
Mailing Address - Street 2:
Mailing Address - City:ELK RIVER
Mailing Address - State:MN
Mailing Address - Zip Code:55330-7731
Mailing Address - Country:US
Mailing Address - Phone:763-441-9009
Mailing Address - Fax:
Practice Address - Street 1:12158 197TH CT NW
Practice Address - Street 2:
Practice Address - City:ELK RIVER
Practice Address - State:MN
Practice Address - Zip Code:55330-7731
Practice Address - Country:US
Practice Address - Phone:763-441-9009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-13
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)