Healthcare Provider Details

I. General information

NPI: 1740667757
Provider Name (Legal Business Name): GLOBAL EXEC AVIATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2015
Last Update Date: 04/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2831 SAINT ROSE PKWY SUITE 200
HENDERSON NV
89052-4840
US

IV. Provider business mailing address

2831 SAINT ROSE PKWY SUITE 200
HENDERSON NV
89052-4840
US

V. Phone/Fax

Practice location:
  • Phone: 702-498-6666
  • Fax:
Mailing address:
  • Phone: 702-498-6666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number
License Number StateNV

VIII. Authorized Official

Name: MR. JOSE GILBERTO NARANJO
Title or Position: VICE PRESIDENT
Credential:
Phone: 702-498-6666