Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Air Transport |
3416A0800X | 59 | Ambulance Service Provider |
| NPI # | 1558427187 |
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| LBN Legal business name | AVERA MCKENNAN | ||||||||||||
| Authorized official | RONALD PLACE - (PRESIDENT/CEO) | ||||||||||||
| Entity | Organization | ||||||||||||
| Organization subpart 1 | No | ||||||||||||
| Enumeration date | 12/28/2006 | ||||||||||||
| Last updated | 10/04/2023 - About 3 years ago | ||||||||||||
| Identifiers |
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AVERA MCKENNAN
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