Healthcare Provider Details

I. General information

NPI: 1255315701
Provider Name (Legal Business Name): AIR EVAC EMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2005
Last Update Date: 08/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19502 E ROGERS POST RD STE 5
CLAREMORE OK
74019
US

IV. Provider business mailing address

PO BOX 106
WEST PLAINS MO
65775-0106
US

V. Phone/Fax

Practice location:
  • Phone: 918-283-8037
  • Fax: 918-283-8039
Mailing address:
  • Phone: 877-288-5340
  • 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