Provider Demographics
NPI:1275548612
Name:AIR AFFILIATES INC
Entity Type:Organization
Organization Name:AIR AFFILIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:L
Authorized Official - Last Name:CURTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-460-0017
Mailing Address - Street 1:PO BOX 90508
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-0508
Mailing Address - Country:US
Mailing Address - Phone:615-460-0017
Mailing Address - Fax:615-463-0107
Practice Address - Street 1:290 NORTH MAIN ST
Practice Address - Street 2:
Practice Address - City:JELLICO
Practice Address - State:TN
Practice Address - Zip Code:37762-2132
Practice Address - Country:US
Practice Address - Phone:423-784-0988
Practice Address - Fax:423-784-0986
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AIR AFFILIATES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-31
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000501332B00000X, 332BX2000X
TN00000018053336C0002X
TN22309335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No3336C0002XSuppliersPharmacyClinic Pharmacy
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY90004185Medicaid
KY54005160OtherFIRST HEALTH
TN000001226566OtherCHA HEALTH
TN040032400OtherDOL DCMWC
TN557723400OtherDOL DCMWC PHARM
TN10293OtherSUNBELT MEDICAL
KY54005160OtherFIRST HEALTH
TN=========OtherHUMANA
TN=========OtherONE NATION
TN040032400OtherDOL DCMWC
KY54005160OtherFIRST HEALTH