Provider Demographics
NPI:1720591209
Name:HAWAII LIFE FLIGHT, LLC
Entity Type:Organization
Organization Name:HAWAII LIFE FLIGHT, LLC
Other - Org Name:HAWAII LIFE FLIGHT
Other - Org Type:Other Name
Authorized Official - Title/Position:SVP OF REV MANAGEMENT
Authorized Official - Prefix:
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:PO BOX 199
Mailing Address - Street 2:
Mailing Address - City:WEST PLAINS
Mailing Address - State:MO
Mailing Address - Zip Code:65775-0199
Mailing Address - Country:US
Mailing Address - Phone:801-619-4900
Mailing Address - Fax:
Practice Address - Street 1:1156 HIALOA ST
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-3283
Practice Address - Country:US
Practice Address - Phone:808-635-8264
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HAWAII LIFE FLIGHT, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-11-07
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport