Provider Demographics
NPI:1144257296
Name:MED-AIR INC
Entity type:Organization
Organization Name:MED-AIR INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:MAGILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-445-8525
Mailing Address - Street 1:PO BOX 220
Mailing Address - Street 2:
Mailing Address - City:TAPPAHANNOCK
Mailing Address - State:VA
Mailing Address - Zip Code:22560-0220
Mailing Address - Country:US
Mailing Address - Phone:804-445-8525
Mailing Address - Fax:804-445-8528
Practice Address - Street 1:1659 TAPPAHANNOCK BOULEVARD
Practice Address - Street 2:
Practice Address - City:TAPPAHANNOCK
Practice Address - State:VA
Practice Address - Zip Code:22560
Practice Address - Country:US
Practice Address - Phone:804-445-8525
Practice Address - Fax:804-445-8528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0206009244332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA173463OtherANTHEM PROVIDER NUMBER
VA173463OtherANTHEM PROVIDER NUMBER