Provider Demographics
NPI:1700976255
Name:BALLARD AVIATION OF HUGO INC
Entity Type:Organization
Organization Name:BALLARD AVIATION OF HUGO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF ADMINISTRATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-764-3343
Mailing Address - Street 1:6601 PUEBLO DR
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67209-2926
Mailing Address - Country:US
Mailing Address - Phone:800-764-3343
Mailing Address - Fax:316-613-4801
Practice Address - Street 1:800 WEST WATKINS BLVD
Practice Address - Street 2:
Practice Address - City:HUGO
Practice Address - State:OK
Practice Address - Zip Code:74743
Practice Address - Country:US
Practice Address - Phone:800-764-3343
Practice Address - Fax:316-613-4801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKEMS8143416A0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport