Healthcare Provider Details

I. General information

NPI: 1154519809
Provider Name (Legal Business Name): TRAVELAIRE SERVICE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2007
Last Update Date: 06/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 SKYWAY ST
PUEBLO CO
81001-4831
US

IV. Provider business mailing address

525 SKYWAY ST
PUEBLO CO
81001-4831
US

V. Phone/Fax

Practice location:
  • Phone: 719-948-3316
  • Fax:
Mailing address:
  • Phone: 719-948-3316
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number
License Number StateCO

VIII. Authorized Official

Name: MRS. JAMIE DEVENCENTY
Title or Position: CFO
Credential:
Phone: 719-948-3316