MEDICARE: MERCY AIR SERVICE, 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	202950	CA
2	3416A0800X	Air Ambulance

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

General Provider Information

NPI Number	:	1700885548
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERCY AIR SERVICE, INC

Provider Business Mailing Address
First Line	:	PO BOX 84621
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98124-5921
Country	:	US
Telephone Number	:	800-499-9495
Fax Number	:	909-890-9895

Provider Business Practice Location Address
First Line	:	13000 LAS VEGAS BLVD S
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89044
Country	:	US
Telephone Number	:	800-499-9495
Fax Number	:	909-890-9895

Authorized Official
Title or Position	:	CAO
Name	:	SHARON J KECK
Credential	:
Telephone Number	:	800-499-9495

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	08/03/2022

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