Provider Demographics
NPI:1902891161
Name:ATI JET INC
Entity type:Organization
Organization Name:ATI JET INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DEEANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:UNDERHILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-527-2767
Mailing Address - Street 1:7007 BOEING DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-1109
Mailing Address - Country:US
Mailing Address - Phone:800-527-2767
Mailing Address - Fax:
Practice Address - Street 1:7007 BOEING DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-1109
Practice Address - Country:US
Practice Address - Phone:800-527-2767
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-14
Last Update Date:2009-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000547201Medicaid
TX000547201Medicaid
TX517822Medicare ID - Type UnspecifiedMEDICARE #