Healthcare Provider Details

I. General information

NPI: 1194173021
Provider Name (Legal Business Name): MED-TRANS CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2016
Last Update Date: 09/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 E DOWNING ST STE 210
TAHLEQUAH OK
74464-3379
US

IV. Provider business mailing address

PO BOX 708
WEST PLAINS MO
65775-0708
US

V. Phone/Fax

Practice location:
  • Phone: 877-288-5340
  • Fax:
Mailing address:
  • Phone: 877-288-5340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: ERIC THOMAS
Title or Position: SVP OF REVENUE MANAGEMENT
Credential:
Phone: 877-288-5340