Healthcare Provider Details

I. General information

NPI: 1164906541
Provider Name (Legal Business Name): RRR AIR EVAC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2018
Last Update Date: 03/18/2022
Certification Date: 03/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 N SHORE LN
GILBERT AZ
85233-5204
US

IV. Provider business mailing address

PO BOX 1561
CHANDLER AZ
85244-1561
US

V. Phone/Fax

Practice location:
  • Phone: 480-719-7153
  • Fax: 308-365-6804
Mailing address:
  • Phone: 517-777-8377
  • Fax: 308-365-6804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: MR. CHEYENNE RENE LORD
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 517-777-8377