Provider Demographics
NPI:1518283852
Name:CENTRAL AIR AMBULANCE. LLC
Entity Type:Organization
Organization Name:CENTRAL AIR AMBULANCE. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:HAL
Authorized Official - Middle Name:F
Authorized Official - Last Name:GENTRY
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-P
Authorized Official - Phone:404-222-0911
Mailing Address - Street 1:205 HEMBREE PARK DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-5732
Mailing Address - Country:US
Mailing Address - Phone:404-222-0911
Mailing Address - Fax:770-874-5827
Practice Address - Street 1:205 HEMBREE PARK DR
Practice Address - Street 2:SUITE 100
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-5732
Practice Address - Country:US
Practice Address - Phone:404-222-0911
Practice Address - Fax:770-874-5827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-12
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport