Provider Demographics
NPI:1154519809
Name:TRAVELAIRE SERVICE, INC.
Entity type:Organization
Organization Name:TRAVELAIRE SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DEVENCENTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-948-3316
Mailing Address - Street 1:525 SKYWAY ST
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81001-4831
Mailing Address - Country:US
Mailing Address - Phone:719-948-3316
Mailing Address - Fax:
Practice Address - Street 1:525 SKYWAY ST
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81001-4831
Practice Address - Country:US
Practice Address - Phone:719-948-3316
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2017-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3416A0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO62643Medicare UPIN