MEDICARE: VIKING AVIATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416A0800X	Air Ambulance	618	AR

General Provider Information

NPI Number	:	1356785539
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIKING AVIATION

Provider Business Mailing Address
First Line	:	PO BOX 1654
Second Line	:
City	:	JONESBORO
State	:	AR
Zip	:	72403-1654
Country	:	US
Telephone Number	:	870-932-5836
Fax Number	:

Provider Business Practice Location Address
First Line	:	6009 DALTON FARMER DR
Second Line	:
City	:	JONESBORO
State	:	AR
Zip	:	72404-8895
Country	:	US
Telephone Number	:	870-932-5836
Fax Number	:

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	MARVIN BAIRD
Credential	:
Telephone Number	:	870-926-6278

Provider Enumeration Date	:	04/18/2013
Last Update Date	:	04/18/2013

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Directions to “VIKING AVIATION ” Practice Location

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