Provider Demographics
NPI:1578540050
Name:AIR TREK, INC.
Entity Type:Organization
Organization Name:AIR TREK, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:W
Authorized Official - Last Name:CARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-639-7855
Mailing Address - Street 1:28000-A5 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33982-2409
Mailing Address - Country:US
Mailing Address - Phone:941-639-7855
Mailing Address - Fax:941-639-0878
Practice Address - Street 1:28000-A5 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33982-2409
Practice Address - Country:US
Practice Address - Phone:941-639-7855
Practice Address - Fax:941-639-0878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-27
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0004073416A0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
397855-AIRTREKOtherGEHA
FL420012801Medicaid
NJ7927801Medicaid
SD9020010Medicaid
MT0441252Medicaid
FL257176OtherAVMED HEALTH PLAN
FL420012800Medicaid
FLA0525OtherBLUE CROSS BLUE SHIELD
FLA0525OtherBLUE CROSS BLUE SHIELD
SD9020010Medicaid