Healthcare Provider Details

I. General information

NPI: 1306851845
Provider Name (Legal Business Name): ENCHANTMENT AVIATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 06/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

670 WINGSPAN HNGR 2
LAS CRUCES NM
88007-9007
US

IV. Provider business mailing address

PO BOX 6119
MESA AZ
85216-6119
US

V. Phone/Fax

Practice location:
  • Phone: 505-525-2660
  • Fax: 505-525-2610
Mailing address:
  • Phone: 800-760-1583
  • Fax: 480-988-3843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MS. MARNIE REDMOND
Title or Position: ASSISTANT DIRECTOR OF PFS
Credential:
Phone: 800-760-1583