Provider Demographics
NPI:1861196248
Name:AVATION MEDICAL, INC.
Entity type:Organization
Organization Name:AVATION MEDICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, FINANCE & HR
Authorized Official - Prefix:
Authorized Official - First Name:JACKIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GERBERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-852-4038
Mailing Address - Street 1:PO BOX 736474
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-6474
Mailing Address - Country:US
Mailing Address - Phone:614-591-4201
Mailing Address - Fax:
Practice Address - Street 1:1375 PERRY ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43201-3177
Practice Address - Country:US
Practice Address - Phone:614-591-4201
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-29
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies