Healthcare Provider Details

I. General information

NPI: 1518483395
Provider Name (Legal Business Name): GUARDIAN FLIGHT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2017
Last Update Date: 08/14/2023
Certification Date: 08/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3409 GOLDENROD AVE
GILLETTE WY
82716-6201
US

IV. Provider business mailing address

PO BOX 199
WEST PLAINS MO
65775-0199
US

V. Phone/Fax

Practice location:
  • Phone: 801-619-4900
  • Fax: 801-983-6052
Mailing address:
  • Phone: 801-619-4900
  • Fax: 801-983-6052

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: SVP OF REVENUE MANAGEMENT
Credential:
Phone: 877-288-5340