Provider Demographics
NPI:1528873833
Name:SHYNE & WELLS TRANSPORTATION SERVICES
Entity type:Organization
Organization Name:SHYNE & WELLS TRANSPORTATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LATRISALA
Authorized Official - Middle Name:
Authorized Official - Last Name:BANKSTON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:832-571-1935
Mailing Address - Street 1:10000 KEDGWICK CT
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71118-4505
Mailing Address - Country:US
Mailing Address - Phone:832-870-8375
Mailing Address - Fax:832-835-2102
Practice Address - Street 1:10000 KEDGWICK CT
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71118-4505
Practice Address - Country:US
Practice Address - Phone:832-870-8375
Practice Address - Fax:832-835-2102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)