Provider Demographics
NPI:1720823776
Name:VARNELL SHAVER LLC
Entity type:Organization
Organization Name:VARNELL SHAVER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMAKIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-902-3193
Mailing Address - Street 1:3815 COTTONPORT RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:TN
Mailing Address - Zip Code:37321-5120
Mailing Address - Country:US
Mailing Address - Phone:423-902-3193
Mailing Address - Fax:
Practice Address - Street 1:3815 COTTONPORT RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:TN
Practice Address - Zip Code:37321-5120
Practice Address - Country:US
Practice Address - Phone:423-902-3193
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-29
Last Update Date:2024-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle