Organization
AERO MED, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSS NEWMAN (PRESIDENT)
(520) 579-8171
Entity
Organization
Contact information
Practice address
7601 E APACHE ST HNGR 22, TULSA, OK 74115-3721
(520) 579-8171
(520) 579-3515
Mailing address
PO BOX 150003, TULSA, OK 74115-0003
(520) 579-8171
(520) 579-3515
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
EMS290
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100819320A
—
OK
05
—
200298930A
—
OK
05
—
533193
—
AZ
01
—
NMB2466
NM MEDICARE
—
01
—
OKB5987
OK MEDICARE
OK
01
—
Z140448
AZ MEDICARE
AZ
Enumeration date
11/07/2011
Last updated
11/07/2011
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