Provider Demographics
NPI:1972846897
Name:CAREFLITE
Entity Type:Organization
Organization Name:CAREFLITE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:H
Authorized Official - Last Name:KYLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-339-4219
Mailing Address - Street 1:3110 S GREAT SOUTHWEST PKWY
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-7238
Mailing Address - Country:US
Mailing Address - Phone:972-339-4219
Mailing Address - Fax:972-988-3144
Practice Address - Street 1:3110 S GREAT SOUTHWEST PKWY
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-7238
Practice Address - Country:US
Practice Address - Phone:972-339-4219
Practice Address - Fax:972-988-3144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-28
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX57066341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance