Healthcare Provider Details

I. General information

NPI: 1053373407
Provider Name (Legal Business Name): MERCY FLIGHT CENTRAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2006
Last Update Date: 12/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2420 BRICKYARD RD
CANANDAIGUA NY
14424-7968
US

IV. Provider business mailing address

PO BOX 535
BALDWINSVILLE NY
13027-0535
US

V. Phone/Fax

Practice location:
  • Phone: 585-396-0584
  • Fax:
Mailing address:
  • Phone: 315-635-1789
  • Fax: 315-635-3289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number10505
License Number StateNY

VIII. Authorized Official

Name: BARBARA A KLEM
Title or Position: SECRETARY TREASURER
Credential:
Phone: 585-396-0584