MEDICARE: OMNIFLIGHT HELICOPTERS, INC.

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	000417	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386730984
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OMNIFLIGHT HELICOPTERS, INC.

Provider Business Mailing Address
First Line	:	PO BOX 6119
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85216-6119
Country	:	US
Telephone Number	:	800-760-1583
Fax Number	:	480-988-3843

Provider Business Practice Location Address
First Line	:	3105 AIRMANS DRIVE
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34946
Country	:	US
Telephone Number	:	772-766-9889
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF COMPLIANCE
Name	:	MARNIE REDMOND
Credential	:
Telephone Number	:	800-760-1583

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	12/01/2010

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