Healthcare Provider Details
I. General information
NPI: 1124905047
Provider Name (Legal Business Name): AIRTRANQUIL LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/20/2025
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5732 CORRADI TER
ACTON CA
93510-1131
US
IV. Provider business mailing address
5732 CORRADI TER
ACTON CA
93510-1131
US
V. Phone/Fax
- Phone: 661-362-8286
- Fax: 661-209-3281
- Phone: 661-362-8286
- Fax: 661-209-3281
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
NOAH
BROCK
Title or Position: CEO
Credential:
Phone: 661-362-8286