Provider Demographics
NPI:1043029697
Name:LUXURY LOGISTICS LLC
Entity type:Organization
Organization Name:LUXURY LOGISTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHAKITA
Authorized Official - Middle Name:TIERRA
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-915-2015
Mailing Address - Street 1:5645 N 86TH PL
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53225-2804
Mailing Address - Country:US
Mailing Address - Phone:414-915-2015
Mailing Address - Fax:
Practice Address - Street 1:5645 N 86TH PL
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53225-2804
Practice Address - Country:US
Practice Address - Phone:414-915-2015
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)