Provider Demographics
NPI:1972775708
Name:ERA MED, LLC
Entity Type:Organization
Organization Name:ERA MED, LLC
Other - Org Name:WELLMONT ONE AIR TRANSPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:GOSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-899-4806
Mailing Address - Street 1:1 EARHART DR
Mailing Address - Street 2:SUITE 11
Mailing Address - City:COATESVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19320-2700
Mailing Address - Country:US
Mailing Address - Phone:610-644-4430
Mailing Address - Fax:
Practice Address - Street 1:401 TAKOMA AVE
Practice Address - Street 2:C/O TAKOMA REGIONAL HOSPITAL
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37743-4647
Practice Address - Country:US
Practice Address - Phone:423-636-0718
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport