Provider Demographics
NPI:1790970481
Name:LIFEFLIGHT EAGLE
Entity Type:Organization
Organization Name:LIFEFLIGHT EAGLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZALAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-283-9716
Mailing Address - Street 1:500 NW RICHARDS RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-4235
Mailing Address - Country:US
Mailing Address - Phone:816-283-9710
Mailing Address - Fax:
Practice Address - Street 1:500 NW RICHARDS RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-4235
Practice Address - Country:US
Practice Address - Phone:816-283-9710
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST JOSEPH MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-09-06
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
260085Medicare Oscar/Certification