Healthcare Provider Details

I. General information

NPI: 1578762308
Provider Name (Legal Business Name): MEDEVAC MIDAMERICA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2007
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 E 9TH ST
PLEASANTON KS
66075-8339
US

IV. Provider business mailing address

PO BOX 847199
DALLAS TX
75284-7199
US

V. Phone/Fax

Practice location:
  • Phone: 913-352-6995
  • Fax:
Mailing address:
  • Phone: 800-913-9106
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: BRIAN SCOTT TIERNEY
Title or Position: EVP, CHIEF FINANCIAL OFFICER
Credential:
Phone: 833-703-2294