Provider Demographics
NPI:1306365994
Name:MERCY AIR SERVICE, INC
Entity Type:Organization
Organization Name:MERCY AIR SERVICE, INC
Other - Org Name:SEMSA AIR
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:
Practice Address - Street 1:205 ASH VALLEY ROAD
Practice Address - Street 2:
Practice Address - City:ADIN
Practice Address - State:CA
Practice Address - Zip Code:96006
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:2017-09-14
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMTA01000FMedicaid