1306808753 NPI number — MERCY FLIGHT INC

Table of content: (NPI 1306808753)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306808753 NPI number — MERCY FLIGHT INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MERCY FLIGHT 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:
6
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:
1306808753
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/27/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 535
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BALDWINSVILLE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
13027-0535
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
315-635-1789
Provider Business Mailing Address Fax Number:
315-635-3289

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 AMHERST VILLA RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BUFFALO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14225-1432
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-626-4100
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/03/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FERRENTINO
Authorized Official First Name:
MARGARET
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
716-626-4100

Provider Taxonomy Codes

  • Taxonomy code: 341600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3416L0300X , with the licence number: 12071 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3416A0800X , with the licence number: 10556 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 10052011 . This is a "CDPHP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 943122 . This is a "MVP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2548729 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000586047001 . This is a "BCBS OF WNY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01653763 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9690627 . This is a "GHI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1012522660001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".