Provider Demographics
NPI:1134114929
Name:MIDWEST CORPORATE AIR CARE LLC
Entity Type:Organization
Organization Name:MIDWEST CORPORATE AIR CARE LLC
Other - Org Name:MIDWEST LIFE TEAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF BILLING SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:H
Authorized Official - Last Name:RATZLAFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-281-8722
Mailing Address - Street 1:PO BOX 672
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:KS
Mailing Address - Zip Code:67114-0672
Mailing Address - Country:US
Mailing Address - Phone:316-281-8722
Mailing Address - Fax:316-281-8723
Practice Address - Street 1:516 N OLIVER RD
Practice Address - Street 2:HANGAR J
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114-9403
Practice Address - Country:US
Practice Address - Phone:316-281-8700
Practice Address - Fax:316-281-8719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-16
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS12553416A0800X, 3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200016100AMedicaid
NE100250094-00Medicaid
CAXMTA06001Medicaid
KS100457300AMedicaid
AR152821715Medicaid
NM81896Medicaid
IA0568378Medicaid
CO12324833Medicaid
TX159261001Medicaid
MO806092201Medicaid
KSP00014137Medicare ID - Type UnspecifiedMEDICARE RAILROAD
IA0568378Medicaid