Provider Demographics
NPI:1922448570
Name:AERO JET MEDICAL
Entity Type:Organization
Organization Name:AERO JET MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:LONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-922-7441
Mailing Address - Street 1:15100 N 78TH WAY
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-2534
Mailing Address - Country:US
Mailing Address - Phone:480-922-7441
Mailing Address - Fax:
Practice Address - Street 1:15100 N 78TH WAY
Practice Address - Street 2:SUITE 203
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2534
Practice Address - Country:US
Practice Address - Phone:480-922-7441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-27
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport
No3416L0300XTransportation ServicesAmbulanceLand Transport