Provider Demographics
NPI:1942726187
Name:CICMF LLC.
Entity Type:Organization
Organization Name:CICMF LLC.
Other - Org Name:CASTLE MEDFLIGHT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF BUSINESS DEVELOPMENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JORDYN
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-829-0110
Mailing Address - Street 1:14362 N FRANK LLOYD WRIGHT BLVD STE 1310
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-8878
Mailing Address - Country:US
Mailing Address - Phone:480-477-7750
Mailing Address - Fax:480-939-4921
Practice Address - Street 1:14362 N FRANK LLOYD WRIGHT BLVD STE 1310
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-8878
Practice Address - Country:US
Practice Address - Phone:480-477-7750
Practice Address - Fax:480-939-4921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7007903416A0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ223467Medicaid