Provider Demographics
NPI:1659391589
Name:AERO MED EXPRESS, INC.
Entity Type:Organization
Organization Name:AERO MED EXPRESS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:MOSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-636-1996
Mailing Address - Street 1:PO BOX 1568
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72757-1568
Mailing Address - Country:US
Mailing Address - Phone:479-636-1996
Mailing Address - Fax:479-636-6620
Practice Address - Street 1:1 MORSANI DRIVE
Practice Address - Street 2:HANGAR 2B
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756
Practice Address - Country:US
Practice Address - Phone:479-636-1996
Practice Address - Fax:479-636-6620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR0013416A0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR101186715Medicaid
AR47387OtherBCBS OF ARKANSAS
AR47387OtherBCBS OF ARKANSAS