Healthcare Provider Details

I. General information

NPI: 1134114929
Provider Name (Legal Business Name): MIDWEST CORPORATE AIR CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2005
Last Update Date: 03/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 N OLIVER RD HANGAR J
NEWTON KS
67114-9403
US

IV. Provider business mailing address

PO BOX 672
NEWTON KS
67114-0672
US

V. Phone/Fax

Practice location:
  • Phone: 316-281-8700
  • Fax: 316-281-8719
Mailing address:
  • Phone: 316-281-8722
  • Fax: 316-281-8723

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number1255
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number1255
License Number StateKS

VIII. Authorized Official

Name: MRS. NANCY H RATZLAFF
Title or Position: DIRECTOR OF BILLING SERVICES
Credential:
Phone: 316-281-8722