Provider Demographics
NPI:1891081469
Name:OMNIFLIGHT HELICOPTERS, INC.
Entity Type:Organization
Organization Name:OMNIFLIGHT HELICOPTERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF COMPLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:MARNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:REDMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-760-1583
Mailing Address - Street 1:PO BOX 6119
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85216-6119
Mailing Address - Country:US
Mailing Address - Phone:800-760-1583
Mailing Address - Fax:480-988-3843
Practice Address - Street 1:4000 VECTOR DR
Practice Address - Street 2:
Practice Address - City:CAHOKIA
Practice Address - State:IL
Practice Address - Zip Code:62206-1466
Practice Address - Country:US
Practice Address - Phone:800-760-1583
Practice Address - Fax:480-988-3843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-22
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL420027600Medicaid
ID808259100Medicaid
NC3406937Medicaid
GA798288525AMedicaid
ID1500013Medicare PIN
NC2783177Medicare PIN
FLU6942Medicare PIN
ID808259100Medicaid