Provider Demographics
NPI:1659724821
Name:ALPHA AIR CENTER LLC
Entity Type:Organization
Organization Name:ALPHA AIR CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL COUNSEL/HIRING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:LANIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-649-1269
Mailing Address - Street 1:9400 STATE HIGHWAY 171
Mailing Address - Street 2:
Mailing Address - City:CARL JUNCTION
Mailing Address - State:MO
Mailing Address - Zip Code:64834-5174
Mailing Address - Country:US
Mailing Address - Phone:417-649-1269
Mailing Address - Fax:
Practice Address - Street 1:5509 DENNIS WEAVER DR
Practice Address - Street 2:
Practice Address - City:WEBB CITY
Practice Address - State:MO
Practice Address - Zip Code:64870-7207
Practice Address - Country:US
Practice Address - Phone:417-623-3113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-22
Last Update Date:2016-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0970823416A0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport