Healthcare Provider Details

I. General information

NPI: 1023551298
Provider Name (Legal Business Name): AIR EVAC EMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2016
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 MOUNT ARARAT RD HNGR 1
DARDEN TN
38328-8541
US

IV. Provider business mailing address

PO BOX 106
WEST PLAINS MO
65775-0106
US

V. Phone/Fax

Practice location:
  • Phone: 877-288-5340
  • Fax: 417-257-5761
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

VII. Legacy identifiers

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

# 1
Identifier106514800
Identifier TypeMEDICAID
Identifier StateFL
Identifier IssuerFlorida Medicaid Provider ID

VIII. Authorized Official

Name: ERIC THOMAS
Title or Position: SENIOR VICE PRESIDENT, REVENUE MGMT
Credential:
Phone: 877-288-5340