Healthcare Provider Details

I. General information

NPI: 1952307126
Provider Name (Legal Business Name): MED FLIGHT AIR AMBULANCE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2005
Last Update Date: 08/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 YALE BLVD SE STE D3
ALBUQUERQUE NM
87106-4355
US

IV. Provider business mailing address

2301 YALE BLVD SE STE D3
ALBUQUERQUE NM
87106-4355
US

V. Phone/Fax

Practice location:
  • Phone: 505-842-4433
  • Fax: 505-842-4436
Mailing address:
  • Phone: 505-842-4433
  • Fax: 505-842-4436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number071005
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number2927L
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number3430
License Number StateNV
# 4
Primary TaxonomyY
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License NumberF00010
License Number StateNM

VIII. Authorized Official

Name: DR. LARRY D LEVY
Title or Position: CEO
Credential: MD
Phone: 505-842-4433