Healthcare Provider Details

I. General information

NPI: 1144565375
Provider Name (Legal Business Name): CSI AVIATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2012
Last Update Date: 06/09/2021
Certification Date: 06/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 RIO GRANDE BLVD NW SUITE 1
ALBUQUERQUE NM
87107-2876
US

IV. Provider business mailing address

3700 RIO GRANDE BLVD NW SUITE 1
ALBUQUERQUE NM
87107-2876
US

V. Phone/Fax

Practice location:
  • Phone: 505-761-9000
  • Fax:
Mailing address:
  • Phone:
  • 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 Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: DEBBIE LYLE-MASON
Title or Position: MEDICAL BILLING MANAGER
Credential:
Phone: 505-342-7382