Provider Demographics
NPI:1063160554
Name:SHUTTLELINER MEDICAL TRANSPORT, LLC
Entity type:Organization
Organization Name:SHUTTLELINER MEDICAL TRANSPORT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:COVO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-888-0407
Mailing Address - Street 1:4240 SE 17TH ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-4906
Mailing Address - Country:US
Mailing Address - Phone:352-888-0407
Mailing Address - Fax:
Practice Address - Street 1:4240 SE 17TH ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-4906
Practice Address - Country:US
Practice Address - Phone:352-888-0407
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-14
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)