Healthcare Provider Details

I. General information

NPI: 1700503109
Provider Name (Legal Business Name): PAFFORD AIR OF MISSISSIPPI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2022
Last Update Date: 02/29/2024
Certification Date: 02/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2610 N STATE ST
CLARKSDALE MS
38614-6101
US

IV. Provider business mailing address

PO BOX 1120
HOPE AR
71802-1120
US

V. Phone/Fax

Practice location:
  • Phone: 800-451-8036
  • Fax: 870-777-8479
Mailing address:
  • Phone: 800-451-8036
  • Fax: 870-777-8479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number
License Number State

VIII. Authorized Official

Name: GREG PAFFORD
Title or Position: PRESIDENT
Credential:
Phone: 800-451-8036