Provider Demographics
NPI:1740358910
Name:CJ SYSTEMS AVIATION GROUP, INC
Entity type:Organization
Organization Name:CJ SYSTEMS AVIATION GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NATIONAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:KEENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-915-2301
Mailing Address - Street 1:275 CURRY HOLLOW RD
Mailing Address - Street 2:SUITE G-300
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15236-4631
Mailing Address - Country:US
Mailing Address - Phone:412-653-2185
Mailing Address - Fax:412-653-6050
Practice Address - Street 1:57 ALLEGHENY COUNTY AIRPORT
Practice Address - Street 2:
Practice Address - City:WEST MIFFLIN
Practice Address - State:PA
Practice Address - Zip Code:15122-2674
Practice Address - Country:US
Practice Address - Phone:412-466-2500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0283416A0800X
AL0807073416A0800X
WI66048293416A0800X, 3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD4993093OtherBCBS SOUTH DAKOTA
WI41361400Medicaid
AL51541040OtherBCBS ALABAMA
AL051558884Medicaid
WI41361500Medicaid
SD9020840Medicaid
AL051558884Medicaid
WI000083137Medicare PIN
SDS101546Medicare PIN