Provider Demographics
NPI:1801897939
Name:CAL-ORE LIFE FLIGHT LLC
Entity type:Organization
Organization Name:CAL-ORE LIFE FLIGHT LLC
Other - Org Name:
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 930
Mailing Address - Street 2:
Mailing Address - City:WEST PLAINS
Mailing Address - State:MO
Mailing Address - Zip Code:65775-0930
Mailing Address - Country:US
Mailing Address - Phone:877-288-5340
Mailing Address - Fax:
Practice Address - Street 1:1800 AIR MEDICAL DR
Practice Address - Street 2:
Practice Address - City:WEST PLAINS
Practice Address - State:MO
Practice Address - Zip Code:65775
Practice Address - Country:US
Practice Address - Phone:877-288-5340
Practice Address - Fax:417-257-5761
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAL-ORE LIFE FLIGHT LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-08-10
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR9903-063416L0300X, 3416A0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR158648Medicaid
CAZZZ14269ZMedicare PIN
CAXMTE06376Medicaid
OR293072Medicaid
CAMTA00959FMedicaid
ORR102146Medicare PIN