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General NPI Number Information
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NPI Number | 1518662998
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Entity Type | Organization
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Legal Business Name | AIR INTERFACILITY TRANSPORT
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Dates
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Enumeration Date | 04/04/2023
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 2505 CLARK CARR LOOP SE
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-5611
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Country | US
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Telephone | 505-787-2095
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2405
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City | SANTA ROSA
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State | CA
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Zip | 95405-0405
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Country | US
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Telephone | 505-535-7149
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Fax |
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Authorized Official
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Title or Position | COO
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Name | JACOB G BENNETT
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Credential |
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Telephone | 575-551-4648
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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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