Provider Demographics
NPI:1306075536
Name:KALITTA CHARTERS, LLC
Entity type:Organization
Organization Name:KALITTA CHARTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDFLIGHT DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:SHANECK
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:734-544-3400
Mailing Address - Street 1:843 WILLOW RUN AIRPORT
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48198-0899
Mailing Address - Country:US
Mailing Address - Phone:734-544-3400
Mailing Address - Fax:734-544-3409
Practice Address - Street 1:843 WILLOW RUN AIRPORT
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48198-0899
Practice Address - Country:US
Practice Address - Phone:734-544-3400
Practice Address - Fax:734-544-3409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-09
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI8210393416A0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport