Provider Demographics
NPI:1457598542
Name:RILEY AVIATION, INC
Entity Type:Organization
Organization Name:RILEY AVIATION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:KIM
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-651-2821
Mailing Address - Street 1:1 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:STURGIS
Mailing Address - State:MI
Mailing Address - Zip Code:49091-8906
Mailing Address - Country:US
Mailing Address - Phone:269-651-2821
Mailing Address - Fax:269-651-9164
Practice Address - Street 1:1 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:STURGIS
Practice Address - State:MI
Practice Address - Zip Code:49091-8906
Practice Address - Country:US
Practice Address - Phone:269-651-2821
Practice Address - Fax:269-651-9164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-12
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport