Provider Demographics
NPI:1518662998
Name:AIR INTERFACILITY TRANSPORT
Entity Type:Organization
Organization Name:AIR INTERFACILITY TRANSPORT
Other - Org Name:AIT AIR MED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:G
Authorized Official - Last Name:BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-551-4648
Mailing Address - Street 1:900 SULLIVAN AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401-7359
Mailing Address - Country:US
Mailing Address - Phone:505-535-7149
Mailing Address - Fax:
Practice Address - Street 1:2505 CLARK CARR LOOP SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-5611
Practice Address - Country:US
Practice Address - Phone:505-787-2095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-04
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport