Provider Demographics
NPI:1821752627
Name:AIR INTERFACILITY TRANSPORT
Entity Type:Organization
Organization Name:AIR INTERFACILITY TRANSPORT
Other - Org Name:AIT AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/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:800-558-8405
Mailing Address - Street 1:10 ROAD 1740
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401-9616
Mailing Address - Country:US
Mailing Address - Phone:575-551-4648
Mailing Address - Fax:
Practice Address - Street 1:2027 CANDELARIA RD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-2032
Practice Address - Country:US
Practice Address - Phone:800-558-8405
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-27
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport