Healthcare Provider Details
I. General information
NPI: 1801879606
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: 09/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
426 W 19TH ST
HOPKINSVILLE KY
42240
US
IV. Provider business mailing address
PO BOX 106
WEST PLAINS MO
65775-0106
US
V. Phone/Fax
- Phone: 270-881-9527
- Fax: 270-881-9588
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3416A0800X |
| Taxonomy | Air Ambulance |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ERIC
THOMAS
Title or Position: SRVP OF REVENUE MANAGEMENT
Credential:
Phone: 877-288-5340