Provider Demographics
NPI:1962097402
Name:OFFSHORE AVIATION LLC
Entity type:Organization
Organization Name:OFFSHORE AVIATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:HICKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-462-0222
Mailing Address - Street 1:45353 SAINT GEORGES AVE
Mailing Address - Street 2:
Mailing Address - City:PINEY POINT
Mailing Address - State:MD
Mailing Address - Zip Code:20674-3112
Mailing Address - Country:US
Mailing Address - Phone:240-462-0222
Mailing Address - Fax:
Practice Address - Street 1:45353 SAINT GEORGES AVE
Practice Address - Street 2:
Practice Address - City:PINEY POINT
Practice Address - State:MD
Practice Address - Zip Code:20674-3112
Practice Address - Country:US
Practice Address - Phone:443-900-8383
Practice Address - Fax:855-243-3200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-06
Last Update Date:2021-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory