Provider Demographics
NPI:1023442829
Name:AMERICAN SHUTTLE LLC
Entity type:Organization
Organization Name:AMERICAN SHUTTLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:ODGLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-694-5003
Mailing Address - Street 1:6353 S SAGINAW RD
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-8140
Mailing Address - Country:US
Mailing Address - Phone:810-694-5003
Mailing Address - Fax:
Practice Address - Street 1:6353 S SAGINAW RD
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-8140
Practice Address - Country:US
Practice Address - Phone:810-694-5003
Practice Address - Fax:810-503-4450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-28
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL3122343800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)