Provider Demographics
NPI:1073178182
Name:MERCY AIR SERVICE, INC.
Entity Type:Organization
Organization Name:MERCY AIR SERVICE, INC.
Other - Org Name:SKYLIFE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CAO
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:J
Authorized Official - Last Name:KECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-499-9495
Mailing Address - Street 1:PO BOX 84621
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-5921
Mailing Address - Country:US
Mailing Address - Phone:800-499-9495
Mailing Address - Fax:402-952-2423
Practice Address - Street 1:5526 E AIRCORP WAY
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-1201
Practice Address - Country:US
Practice Address - Phone:800-499-9495
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AIR METHODS CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-03
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMTA00597FMedicaid