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General NPI Number Information
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NPI Number | 1013294982
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Entity Type | Organization
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Legal Business Name | AERO MED, LLC
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Dates
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Enumeration Date | 11/07/2011
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Last Update Date | 11/07/2011
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Provider Practice Location Address
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Address Line | 7601 E APACHE ST HNGR 22
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City | TULSA
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State | OK
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Zip | 74115-3721
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Country | US
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Telephone | 520-579-8171
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Fax | 520-579-3515
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Provider Business Mailing Address
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Address Line | PO BOX 150003
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City | TULSA
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State | OK
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Zip | 74115-0003
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Country | US
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Telephone | 520-579-8171
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Fax | 520-579-3515
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Authorized Official
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Title or Position | PRESIDENT
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Name | RUSS NEWMAN
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Credential |
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Telephone | 520-579-8171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | EMS290
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License Number State | OK
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