Healthcare Provider Details

I. General information

NPI: 1740515634
Provider Name (Legal Business Name): MEDFLIGHT911 AIR AMBULANCE SERVICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2009
Last Update Date: 05/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16772 W BELL RD SUITE 110-274
SURPRISE AZ
85374-9702
US

IV. Provider business mailing address

16772 W BELL RD SUITE 110-274
SURPRISE AZ
85374-9702
US

V. Phone/Fax

Practice location:
  • Phone: 888-359-1911
  • Fax: 888-571-3735
Mailing address:
  • Phone: 888-359-1911
  • Fax: 888-571-3735

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3416S0300X
TaxonomyWater Ambulance
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIAM D MCCLUSKEY
Title or Position: PRESIDENT/CEO
Credential:
Phone: 888-359-1911