Provider Demographics
NPI:1568460863
Name:ACCESS AIR AMBULANCE
Entity Type:Organization
Organization Name:ACCESS AIR AMBULANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:HUTCHENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-389-9906
Mailing Address - Street 1:3647 RICKENBACKER ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83705-5022
Mailing Address - Country:US
Mailing Address - Phone:208-433-9850
Mailing Address - Fax:208-331-4533
Practice Address - Street 1:1655 THOMAS GALLAGHER WAY
Practice Address - Street 2:
Practice Address - City:ELKO
Practice Address - State:NV
Practice Address - Zip Code:89801-7849
Practice Address - Country:US
Practice Address - Phone:775-738-3493
Practice Address - Fax:775-738-3494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV84333416A0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV=========OtherEIN
NV=========OtherEIN