=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508672064
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AIRWAYS MEDICAL, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/09/2024
-----------------------------------------------------
Last Update Date | 08/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2350 LAKEWOOD DR STE B
-----------------------------------------------------
City | CABOT
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72023-7058
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 501-446-9040
-----------------------------------------------------
Fax | 501-446-9041
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6414 S 118TH ST
-----------------------------------------------------
City | OMAHA
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68137-3576
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-281-4404
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | COMPLIANCE OFFICER
-----------------------------------------------------
Name | SHEILA ROBERSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 602-818-5258
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332BX2000X
-----------------------------------------------------
Taxonomy Name | Oxygen Equipment & Supplies (DME)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------