Provider Demographics
NPI:1912301326
Name:MEDICAL AIR SERVICES ASSOCIATION
Entity Type:Organization
Organization Name:MEDICAL AIR SERVICES ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TRANSPORT DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DUSTY
Authorized Official - Middle Name:
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-430-4655
Mailing Address - Street 1:1250 W SOUTHLAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-6013
Mailing Address - Country:US
Mailing Address - Phone:817-430-4655
Mailing Address - Fax:817-491-1368
Practice Address - Street 1:1250 W SOUTHLAKE BLVD
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-6013
Practice Address - Country:US
Practice Address - Phone:817-430-4655
Practice Address - Fax:817-491-1368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-14
Last Update Date:2014-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport