Healthcare Provider Details

I. General information

NPI: 1922407022
Provider Name (Legal Business Name): PHOENIX LIFEFLIGHT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2014
Last Update Date: 08/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14362 N FRANK LLOYD WRIGHT BLVD 2136
SCOTTSDALE AZ
85260-8846
US

IV. Provider business mailing address

14362 N FRANK LLOYD WRIGHT BLVD 2136
SCOTTSDALE AZ
85260-8846
US

V. Phone/Fax

Practice location:
  • Phone: 602-529-0905
  • Fax:
Mailing address:
  • Phone: 602-529-0905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code344800000X
TaxonomyAir Carrier
License Number
License Number State

VIII. Authorized Official

Name: MR. JAYSON PAPA
Title or Position: PRESIDENT/CEO
Credential: CCEMTP-T/ATP
Phone: 602-529-0905