Healthcare Provider Details

I. General information

NPI: 1306075536
Provider Name (Legal Business Name): KALITTA CHARTERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2009
Last Update Date: 07/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

843 WILLOW RUN AIRPORT
YPSILANTI MI
48198-0899
US

IV. Provider business mailing address

843 WILLOW RUN AIRPORT
YPSILANTI MI
48198-0899
US

V. Phone/Fax

Practice location:
  • Phone: 734-544-3400
  • Fax: 734-544-3409
Mailing address:
  • Phone: 734-544-3400
  • Fax: 734-544-3409

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number821039
License Number StateMI

VIII. Authorized Official

Name: MS. LORI SHANECK
Title or Position: MEDFLIGHT DIRECTOR
Credential: R.N.
Phone: 734-544-3400