Provider Demographics
NPI:1285625434
Name:A.L.S. AEROCARE, INC.
Entity type:Organization
Organization Name:A.L.S. AEROCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:HELEN
Authorized Official - Last Name:BRUNNER
Authorized Official - Suffix:
Authorized Official - Credentials:RN,BSN,CFN
Authorized Official - Phone:612-539-2222
Mailing Address - Street 1:14815 41ST AVE N
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55446-2754
Mailing Address - Country:US
Mailing Address - Phone:612-539-2222
Mailing Address - Fax:763-572-2194
Practice Address - Street 1:14815 41ST AVE N
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55446-2754
Practice Address - Country:US
Practice Address - Phone:612-539-2222
Practice Address - Fax:763-572-2194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-04
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN16883416A0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN81-00029OtherMEDICA
MN50P06ALOtherBLUE CROSS/BLUE SH
MN198492600Medicaid
MN590000071Medicare ID - Type UnspecifiedFIXED WING AIR MEDICAL TR