Healthcare Provider Details

I. General information

NPI: 1710797873
Provider Name (Legal Business Name): BENTEH MEDEVAC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2025
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1744 N PROSPECT DR
PALMER AK
99645-9655
US

IV. Provider business mailing address

2521 E MTN VILL DR STE B PMB 405
WASILLA AK
99654
US

V. Phone/Fax

Practice location:
  • Phone: 907-373-7991
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: GILLIAN WRIGHT
Title or Position: BILLING & PROGRAM MANAGER
Credential:
Phone: 907-671-6871