Healthcare Provider Details

I. General information

NPI: 1942682844
Provider Name (Legal Business Name): AIR RESCUE SYSTEMS CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2015
Last Update Date: 06/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 JEFFERSON AVE
ASHLAND OR
97520-3703
US

IV. Provider business mailing address

PO BOX 3009
ASHLAND OR
97520-0301
US

V. Phone/Fax

Practice location:
  • Phone: 541-488-0941
  • Fax:
Mailing address:
  • Phone: 541-488-0941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License NumberBV0A2221
License Number State
# 2
Primary TaxonomyN
Taxonomy Code344800000X
TaxonomyAir Carrier
License NumberBV0A2221
License Number State

VIII. Authorized Official

Name: BURL J BRIM
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 541-482-1008