Organization
MOUNTAIN LIFEFLIGHT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY REGER (CEO)
(530) 257-0249
Entity
Organization
Contact information
Practice address
650 ASH ST, SUSANVILLE, CA 96130-3714
(530) 257-0249
Mailing address
PO BOX 711, SUSANVILLE, CA 96130-0711
Taxonomy
Speciality
Code
Description
License number
State
3416A0800X
Air Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MTA00754F
—
CA
Enumeration date
10/18/2006
Last updated
09/19/2007
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