Provider Demographics
NPI:1922407022
Name:PHOENIX LIFEFLIGHT
Entity Type:Organization
Organization Name:PHOENIX LIFEFLIGHT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAYSON
Authorized Official - Middle Name:
Authorized Official - Last Name:PAPA
Authorized Official - Suffix:
Authorized Official - Credentials:CCEMTP-T/ATP
Authorized Official - Phone:602-529-0905
Mailing Address - Street 1:14362 N FRANK LLOYD WRIGHT BLVD
Mailing Address - Street 2:2136
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-8846
Mailing Address - Country:US
Mailing Address - Phone:602-529-0905
Mailing Address - Fax:
Practice Address - Street 1:14362 N FRANK LLOYD WRIGHT BLVD
Practice Address - Street 2:2136
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-8846
Practice Address - Country:US
Practice Address - Phone:602-529-0905
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-14
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport
No344800000XTransportation ServicesAir Carrier