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General NPI Number Information
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NPI Number | 1922407022
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Entity Type | Organization
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Legal Business Name | PHOENIX LIFEFLIGHT
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Dates
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Enumeration Date | 08/14/2014
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Last Update Date | 08/14/2014
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Provider Practice Location Address
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Address Line | 14362 N FRANK LLOYD WRIGHT BLVD 2136
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-8846
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Country | US
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Telephone | 602-529-0905
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Fax |
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Provider Business Mailing Address
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Address Line | 14362 N FRANK LLOYD WRIGHT BLVD 2136
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-8846
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Country | US
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Telephone | 602-529-0905
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. JAYSON PAPA
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Credential | CCEMTP-T/ATP
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Telephone | 602-529-0905
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 344800000X
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Taxonomy Name | Air Carrier
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License Number |
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License Number State |
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Taxonomy #2
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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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