Healthcare Provider Details

I. General information

NPI: 1790768505
Provider Name (Legal Business Name): AIR EVAC EMS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2005
Last Update Date: 02/07/2025
Certification Date: 02/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 FIREBAUGH DR STE A
MOUNT VERNON IL
62864-6796
US

IV. Provider business mailing address

PO BOX 106
WEST PLAINS MO
65775-0106
US

V. Phone/Fax

Practice location:
  • Phone: 877-288-5340
  • Fax: 417-257-5761
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number
License Number State

VIII. Authorized Official

Name: ERIC THOMAS
Title or Position: SENIOR VICE PRESIDENT, REVENUE MGMT
Credential:
Phone: 877-288-5340