Provider Demographics
NPI:1962619817
Name:MEDWAY AIR AMBULANCE LLC
Entity type:Organization
Organization Name:MEDWAY AIR AMBULANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT BUSINESS DEVELOPMENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-963-1412
Mailing Address - Street 1:PO BOX 490907
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30049-0016
Mailing Address - Country:US
Mailing Address - Phone:770-963-1412
Mailing Address - Fax:
Practice Address - Street 1:570 BRISCOE BLVD
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-4637
Practice Address - Country:US
Practice Address - Phone:478-714-8838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport