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General NPI Number Information
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NPI Number | 1679887079
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Entity Type | Organization
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Legal Business Name | APACHE MED TRANS LLC
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Dates
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Enumeration Date | 07/28/2010
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Last Update Date | 11/18/2011
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Provider Practice Location Address
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Address Line | 60 E. RIO SALADO PARKWAY SUITE 900
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City | TEMPE
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State | AZ
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Zip | 85281
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Country | US
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Telephone | 913-663-5535
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Fax | 913-663-1503
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Provider Business Mailing Address
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Address Line | PO BOX 26785
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City | OVERLAND PARK
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State | KS
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Zip | 66225-6785
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Country | US
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Telephone | 913-663-5535
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Fax | 913-663-1503
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DAVID CARL CARLSON
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Credential |
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Telephone | 913-663-5535
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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 | AZ
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