Provider Demographics
NPI:1801919949
Name:AIR SITKA
Entity type:Organization
Organization Name:AIR SITKA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:BELLOWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-747-7920
Mailing Address - Street 1:485 KATLIAN ST
Mailing Address - Street 2:
Mailing Address - City:SITKA
Mailing Address - State:AK
Mailing Address - Zip Code:99835-7506
Mailing Address - Country:US
Mailing Address - Phone:907-747-7920
Mailing Address - Fax:907-747-6090
Practice Address - Street 1:485 KATLIAN ST
Practice Address - Street 2:
Practice Address - City:SITKA
Practice Address - State:AK
Practice Address - Zip Code:99835-7506
Practice Address - Country:US
Practice Address - Phone:907-747-7920
Practice Address - Fax:907-747-6090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK3011603416A0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKAL3011Medicaid