Provider Demographics
NPI:1225218407
Name:ENCHANTMENT AVIATION
Entity Type:Organization
Organization Name:ENCHANTMENT AVIATION
Other - Org Name:SOUTHWEST MED EVAC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARNIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:REDMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-988-3840
Mailing Address - Street 1:6402 E SUPERSTITION SPRINGS BLVD
Mailing Address - Street 2:SUITE 224
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-4392
Mailing Address - Country:US
Mailing Address - Phone:480-988-3840
Mailing Address - Fax:480-988-3843
Practice Address - Street 1:2805B LAS VEGAS CT
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88007-4164
Practice Address - Country:US
Practice Address - Phone:505-527-2166
Practice Address - Fax:505-525-2610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-06
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMTK040802013416A0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport