Provider Demographics
NPI:1275829079
Name:SHELL'S SHUTTLE LLC
Entity Type:Organization
Organization Name:SHELL'S SHUTTLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:F
Authorized Official - Last Name:MOFFAT
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:715-846-5989
Mailing Address - Street 1:2429 CHARLOTTE CT
Mailing Address - Street 2:#8
Mailing Address - City:ANTIGO
Mailing Address - State:WI
Mailing Address - Zip Code:54409-2970
Mailing Address - Country:US
Mailing Address - Phone:715-846-5989
Mailing Address - Fax:
Practice Address - Street 1:2429 CHARLOTTE CT
Practice Address - Street 2:#8
Practice Address - City:ANTIGO
Practice Address - State:WI
Practice Address - Zip Code:54409-2970
Practice Address - Country:US
Practice Address - Phone:715-846-5989
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-21
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI273JTT344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi