Provider Demographics
NPI:1497963110
Name:AIR EVAC EMS INC
Entity type:Organization
Organization Name:AIR EVAC EMS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
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:877-288-5340
Mailing Address - Fax:
Practice Address - Street 1:1620 SANTA FE ST
Practice Address - Street 2:
Practice Address - City:WOODWARD
Practice Address - State:OK
Practice Address - Zip Code:73801
Practice Address - Country:US
Practice Address - Phone:580-256-2208
Practice Address - Fax:580-256-2314
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AIR EVAC EMS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-18
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
AEL-070 WOODWARDOtherBASE ID