Provider Demographics
NPI:1790154391
Name:AIR EVAC EMS, INC.
Entity Type:Organization
Organization Name:AIR EVAC EMS, INC.
Other - Org Name:AIR EVAC LIFETEAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP OF REVENUE 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 106
Mailing Address - Street 2:
Mailing Address - City:WEST PLAINS
Mailing Address - State:MO
Mailing Address - Zip Code:65775-0106
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:311 FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:PONCA CITY
Practice Address - State:OK
Practice Address - Zip Code:74601-2002
Practice Address - Country:US
Practice Address - Phone:580-749-5442
Practice Address - Fax:417-257-5761
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AIR EVAC EMS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-09-24
Last Update Date:2018-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport