Healthcare Provider Details

I. General information

NPI: 1275548612
Provider Name (Legal Business Name): AIR AFFILIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 12/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

290 NORTH MAIN ST
JELLICO TN
37762-2132
US

IV. Provider business mailing address

PO BOX 90508
NASHVILLE TN
37209-0508
US

V. Phone/Fax

Practice location:
  • Phone: 423-784-0988
  • Fax: 423-784-0986
Mailing address:
  • Phone: 615-460-0017
  • Fax: 615-463-0107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number0000000501
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number0000000501
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number0000001805
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number22309
License Number StateTN

VIII. Authorized Official

Name: MARK L CURTIS
Title or Position: CFO
Credential:
Phone: 615-460-0017