Provider Demographics
NPI:1508427352
Name:APOLLO MEDFLIGHT, LLC
Entity Type:Organization
Organization Name:APOLLO MEDFLIGHT, LLC
Other - Org Name:APOLLO MEDFLIGHT - AIR RESCUE
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:DORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-359-4699
Mailing Address - Street 1:PO BOX 63
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79105-0063
Mailing Address - Country:US
Mailing Address - Phone:806-242-9028
Mailing Address - Fax:888-978-5029
Practice Address - Street 1:12 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:PINE RIDGE
Practice Address - State:SD
Practice Address - Zip Code:57770
Practice Address - Country:US
Practice Address - Phone:806-322-4448
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-24
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD2020116Medicaid