Healthcare Provider Details

I. General information

NPI: 1467435461
Provider Name (Legal Business Name): AIR EVAC EMS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 08/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6945 N US HIGHWAY 45
WATSON IL
62473
US

IV. Provider business mailing address

PO BOX 106
WEST PLAINS MO
65775-0106
US

V. Phone/Fax

Practice location:
  • Phone: 217-536-9341
  • Fax: 217-536-9343
Mailing address:
  • Phone: 417-257-1585
  • Fax: 417-257-5761

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: SRVP OF REVENUE MANAGEMENT
Credential:
Phone: 877-288-5340