MEDICARE: AIR TREK, 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	000407	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	397855-AIRTREK	OTHER		GEHA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	257176	OTHER	FL	AVMED HEALTH PLAN
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	A0525	OTHER	FL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1578540050
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AIR TREK, INC.

Provider Business Mailing Address
First Line	:	28000-A5 AIRPORT RD
Second Line	:
City	:	PUNTA GORDA
State	:	FL
Zip	:	33982-2409
Country	:	US
Telephone Number	:	941-639-7855
Fax Number	:	941-639-0878

Provider Business Practice Location Address
First Line	:	28000-A5 AIRPORT RD
Second Line	:
City	:	PUNTA GORDA
State	:	FL
Zip	:	33982-2409
Country	:	US
Telephone Number	:	941-639-7855
Fax Number	:	941-639-0878

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	DANA W. CARR
Credential	:
Telephone Number	:	941-639-7855

Provider Enumeration Date	:	12/27/2005
Last Update Date	:	07/31/2009

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Directions to “AIR TREK, INC. ” Practice Location

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