Healthcare Provider Details

I. General information

NPI: 1467686782
Provider Name (Legal Business Name): AIR AMBULANCE NETWORK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2009
Last Update Date: 05/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3231 VALEMOOR DR
PALM HARBOR FL
34685-1714
US

IV. Provider business mailing address

3231 VALEMOOR DR
PALM HARBOR FL
34685-1714
US

V. Phone/Fax

Practice location:
  • Phone: 727-789-2800
  • Fax:
Mailing address:
  • Phone: 727-789-2800
  • 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 Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: MR. KIRK C PACHECO
Title or Position: CEO
Credential:
Phone: 727-789-2800