Provider Demographics
NPI:1083746416
Name:470 ABS MEDICAL FLIGHT
Entity Type:Organization
Organization Name:470 ABS MEDICAL FLIGHT
Other - Org Name:U.S. CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:MEDICAL FLIGHT COMMANDER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:REISER
Authorized Official - Suffix:
Authorized Official - Credentials:MSC
Authorized Official - Phone:49245-199-3300
Mailing Address - Street 1:470 ABS US CLINIC
Mailing Address - Street 2:UNIT 8030
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09104
Mailing Address - Country:DE
Mailing Address - Phone:49245-199-3300
Mailing Address - Fax:
Practice Address - Street 1:470 ABS US CLINIC
Practice Address - Street 2:UNIT 8030
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09104
Practice Address - Country:DE
Practice Address - Phone:49245-199-3300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization