MEDICARE: AITHERAS AVIATION GROUP LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416A0800X	Air Ambulance	184113	OH

General Provider Information

NPI Number	:	1821311630
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AITHERAS AVIATION GROUP LLC

Provider Business Mailing Address
First Line	:	1601 N MARGINAL RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44114-3739
Country	:	US
Telephone Number	:	216-298-9060
Fax Number	:	216-298-9068

Provider Business Practice Location Address
First Line	:	1601 N MARGINAL RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44114-3739
Country	:	US
Telephone Number	:	216-298-9060
Fax Number	:	216-298-9068

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	MR. GEORGE K KATSIKAS
Credential	:
Telephone Number	:	216-298-9060

Provider Enumeration Date	:	03/08/2010
Last Update Date	:	03/08/2010

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