Healthcare Provider Details

I. General information

NPI: 1295740660
Provider Name (Legal Business Name): EAL LEASING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 11/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 AIRPORT WAY
KLAMATH FALLS OR
97603-1961
US

IV. Provider business mailing address

2901 AIRPORT WAY
KLAMATH FALLS OR
97603-1961
US

V. Phone/Fax

Practice location:
  • Phone: 888-988-4911
  • Fax:
Mailing address:
  • Phone: 888-988-4911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number11442
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number0601
License Number StateOR

VIII. Authorized Official

Name: EDWARD A LANGERVELD
Title or Position: OWNER
Credential:
Phone: 888-988-4911