Provider Demographics
NPI:1780671487
Name:SUN WESTERN FLYERS, INC
Entity Type:Organization
Organization Name:SUN WESTERN FLYERS, INC
Other - Org Name:SUN CARE AIR AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:C.E.O
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:L
Authorized Official - Last Name:EWING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-726-4715
Mailing Address - Street 1:2095 E 32ND ST
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85365-3545
Mailing Address - Country:US
Mailing Address - Phone:928-726-4715
Mailing Address - Fax:928-344-5129
Practice Address - Street 1:2095 E 32ND ST
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85365-3545
Practice Address - Country:US
Practice Address - Phone:928-726-4715
Practice Address - Fax:928-344-5129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-29
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3416A0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAXMTA05770Medicaid
AZ804618Medicaid
CAXMTA05770Medicaid
AZRGAAKMedicare ID - Type Unspecified