Provider Demographics
NPI:1689913378
Name:AIRSQUID VENTURES INC.
Entity Type:Organization
Organization Name:AIRSQUID VENTURES INC.
Other - Org Name:AMPHIBIOUS MEDICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DONOGHUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-878-9185
Mailing Address - Street 1:2633 E 28TH ST
Mailing Address - Street 2:#622
Mailing Address - City:SIGNAL HILL
Mailing Address - State:CA
Mailing Address - Zip Code:90755-2243
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2633 E 28TH ST
Practice Address - Street 2:#622
Practice Address - City:SIGNAL HILL
Practice Address - State:CA
Practice Address - Zip Code:90755-2243
Practice Address - Country:US
Practice Address - Phone:877-878-9185
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-31
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Multi-Specialty