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General NPI Number Information
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NPI Number | 1215493887
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Entity Type | Organization
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Legal Business Name | ASI CHARTER, INC
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Dates
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Enumeration Date | 02/19/2019
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Last Update Date | 02/19/2019
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Provider Practice Location Address
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Address Line | 12420 E CONTROL TOWER RD
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City | ENGLEWOOD
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State | CO
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Zip | 80112-4144
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Country | US
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Telephone | 720-649-0700
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Fax |
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Provider Business Mailing Address
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Address Line | 12420 E CONTROL TOWER RD
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City | ENGLEWOOD
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State | CO
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Zip | 80112-4144
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Country | US
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Telephone | 720-649-0700
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. EUGENE VAUGHN HAGGEN
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Credential |
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Telephone | 720-649-0700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416A0800X
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Taxonomy Name | Air Ambulance
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License Number |
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License Number State |
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