Provider Demographics
NPI:1982879789
Name:FRONTIER LEASING LMTD PAR
Entity Type:Organization
Organization Name:FRONTIER LEASING LMTD PAR
Other - Org Name:LOVEAIR HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:LOVE
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:801-973-0900
Mailing Address - Street 1:353 N. 4TH AVENUE
Mailing Address - Street 2:STE 205
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83201-6392
Mailing Address - Country:US
Mailing Address - Phone:208-478-6677
Mailing Address - Fax:208-478-2618
Practice Address - Street 1:353 N. 4TH AVENUE
Practice Address - Street 2:STE 205
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83201-6392
Practice Address - Country:US
Practice Address - Phone:208-478-6677
Practice Address - Fax:208-478-2618
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRONTIER LEASING LMTD PAR
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-23
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5650847332B00000X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT=========01Medicaid
UT5108790001Medicare NSC