Healthcare Provider Details

I. General information

NPI: 1104292192
Provider Name (Legal Business Name): MEDX AIRONE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2015
Last Update Date: 04/08/2021
Certification Date: 04/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2705 CYRANO ST
HENDERSON NV
89044-0303
US

IV. Provider business mailing address

1010 N 500 E STE 200
NORTH SALT LAKE UT
84054-1952
US

V. Phone/Fax

Practice location:
  • Phone: 702-815-5059
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number08486
License Number StateNV

VIII. Authorized Official

Name: JOEL HOCHHALTER
Title or Position: MANAGING MEMBER
Credential:
Phone: 702-815-5059