Provider Demographics
NPI:1861502791
Name:NATIVE AMERICAN AIR AMBULANCE, INC.
Entity Type:Organization
Organization Name:NATIVE AMERICAN AIR AMBULANCE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF COMPLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:MARNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:REDMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-988-3840
Mailing Address - Street 1:6402 E SUPERSTITION SPRINGS BLVD
Mailing Address - Street 2:SUITE 224
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-4392
Mailing Address - Country:US
Mailing Address - Phone:480-988-3840
Mailing Address - Fax:480-988-3843
Practice Address - Street 1:6402 E SUPERSTITION SPRINGS BLVD
Practice Address - Street 2:SUITE 224
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4392
Practice Address - Country:US
Practice Address - Phone:480-988-3840
Practice Address - Fax:480-988-3843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ804668Medicaid
AZZRMBBPMedicare ID - Type UnspecifiedPROVIDER NUMBER
MT000020032Medicare PIN