1275548612 NPI number — AIR AFFILIATES INC

Table of content: (NPI 1275548612)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275548612 NPI number — AIR AFFILIATES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AIR AFFILIATES INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275548612
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/10/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 90508
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37209-0508
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-460-0017
Provider Business Mailing Address Fax Number:
615-463-0107

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
290 NORTH MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JELLICO
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37762-2132
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-784-0988
Provider Business Practice Location Address Fax Number:
423-784-0986
Provider Enumeration Date:
07/31/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CURTIS
Authorized Official First Name:
MARK
Authorized Official Middle Name:
L
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
615-460-0017

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  0000000501 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332BX2000X , with the licence number: 0000000501 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0002X , with the licence number: 0000001805 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 335E00000X , with the licence number: 22309 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 90004185 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 54005160 . This is a "FIRST HEALTH" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 000001226566 . This is a "CHA HEALTH" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 040032400 . This is a "DOL DCMWC" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 557723400 . This is a "DOL DCMWC PHARM" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 10293 . This is a "SUNBELT MEDICAL" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".