Organization
EXECUTIVE AIR TAXI CORP.
Active
Other names
Angel Air Care
Organization subpart
No
Provider details
NPI number
Authorized official
CALLEN CERMAK (CFO)
(701) 258-5024
Entity
Organization
Contact information
Practice address
8295 7TH AVE SE, LINTON, ND 58552-9011
(701) 254-5755
Mailing address
2301 UNIVERSITY DR, BISMARCK, ND 58504-7595
(701) 258-5024
(701) 258-2693
Taxonomy
Speciality
Code
Description
License number
State
3416A0800X
Air Ambulance
0982
SD
3416A0800X
Air Ambulance
Primary
681
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
54188
—
ND
Enumeration date
10/15/2010
Last updated
04/25/2011
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