Provider Demographics
NPI:1639498967
Name:HAWAII LIFE FLIGHT INC.
Entity Type:Organization
Organization Name:HAWAII LIFE FLIGHT INC.
Other - Org Name:HAWAII LIFE FLIGHT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP OF REVENUE MANAGEMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-288-5340
Mailing Address - Street 1:10888 S 300 W
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-4043
Mailing Address - Country:US
Mailing Address - Phone:801-619-4900
Mailing Address - Fax:801-619-8077
Practice Address - Street 1:150 LAGOON DR
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819
Practice Address - Country:US
Practice Address - Phone:801-619-4900
Practice Address - Fax:801-983-6052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-26
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3416A0800X
HI12-0083416A0800X
HI17-0103416A0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI644684Medicaid
HI644684Medicaid